Sleep Tips for Babies with Reflux

The Pediatrician Mom

photo by: @happilyeveralbertson

Parents whose babies have reflux are often frustrated and overwhelmed – specifically when it comes to sleep. Sleep can be stressful when your little one is uncomfortable and suffers from reflux.  But before trying all the different tips and tricks you can find on the internet, it’s important to understand that many of these can be unsafe. 

As a parent, we want to make sure the information we have is reliable and based in evidence. So here is a basic overview of reflux that can help…safely.

What is reflux?

Almost all babies “reflux” to some extent because of immature anatomy; the muscle band that lies between the esophagus and the stomach is immature and does not function well and can lead to the stomach contents being pushed backwards up the feeding tube (esophagus). For most babies, this isn’t actually a problem: it leads to spitting up, but not any other significant discomfort.

But for some babies, it can lead to a lot of distress. This is the point where we begin to think of reflux as a disease. Parents will frequently describe fussier babies who are not sleeping, having difficulty (or taking a long time with) feeding, spitting up, and are not gaining weight as having reflux.

How does reflux affect sleep?

When a baby is lying flat, stomach contents are more likely to be pushed upwards. So, the recommendations for a safe sleep environment (flat, firm mattress without anything else in the sleep space) have the potential to make reflux worse.

Unfortunately, many products are marketed as “add-ons” to the sleep space to help decrease the spit-up volume, such as wedges and positioners. In fact, many sleep specialists and even pediatric healthcare providers recommend putting blankets under the head of the crib mattress as an alternative.

Let me be clear: studies have not shown that these adjustments are helpful, and in fact they can be unsafe because of a risk of blocking off a baby’s airway. 

So, what’s a parent to do?

Tips for reflux that actually help:

• Start with small, more frequent feeds
• Keep your baby upright for 20-30 minutes after every feed
• This helps for some babies: burp half-way through and then again after a feed.
• Check how feeding is going; make sure you have discussed your baby’s latch with your pediatrician or lactation consultant. Some babies with difficulty latching because of tongue or lip ties exhibit reflux symptoms.
• Change milk flow - if the flow is too rapid, or too slow, a baby may swallow more air. This may mean changing the way you feed or the flow of the nipple for bottle fed babies.
• Try to have some time between feeding and sleep. Approximately 20-30 minutes can help.
• Talk to your pediatrician about the possibility of other issues; in very rare situations, reflux can be a sign of a protein intolerance (such as a cow’s milk protein intolerance). Do not eliminate items from your diet without first discussing with your healthcare provider.
• Ultimately, some babies need medications to help with reflux symptoms as well.

At the end of the day, there are three points to remember:

• For most babies, reflux improves around the 6-month mark.
• Your goal is not necessarily to stop the spit-up. It is to decrease the discomfort. Spit-up happens. You want to make sure that overall your baby feels comfortable.
• Make sure you reach out for help if you feel overwhelmed or hopeless. Parenting a reflux baby is exhausting and frustrating, and taking a break is important for everyone’s wellbeing.

Following these tips will help to reduce reflux symptoms, making your baby more comfortable, which can foster better sleep. Hang in there! You got this!

About Dr. Krupa Playforth, MD

As a board-certified pediatrician and mother, Dr. Playforth’s mission is to create a safe space with practical and educational content for parents. In today’s world of misinformation, she believes every parent deserves clear, evidence-based, nuanced answers to help them feel empowered and equipped on the parenting journey.

For more information, check out @thepediatricianmom and thepediatricianmom.com.

Content is not intended to be a substitute for professional medical advice.  Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.