Silent reflux is a bastard. It’s tricky to diagnose and exhausting to manage. G Major had it, and I caught it, amazingly, in the first two weeks. But only because both my mother and I had had reflux, and I was on the lookout for issues, and because a friend’s baby had suffered with diagnosed silent reflux, and I was familiar with the signs.
Compared to ‘normal’ reflux, the lack of exorcist puking makes silent reflux difficult to diagnose. Symptoms of silent reflux typically include: crying after feeding; arching their back; persistent hiccuping and coughing; extended suckling and excessive feeding to sooth the burning. You may also see milk being regurgitated into the mouth.
Because your baby keeps feeds down, as opposed to projectile vomiting them across the room, it’s likely the’re gaining weight well. You don’t have that permanent sour milk vom smell attached to you and it’s safe to venture out of the house without a whole separate bag of muslins. So people, and your GP, might be unsympathetic. They won’t understand that you and your partner literally, genuinely, hold your baby 24/7.
I actually cried when G Minor fell asleep flat in her basket seconds after taking a massive feed. I had no idea it could work like that.
The good news is, silent reflux doesn’t last forever. In the meantime, here’s some advice from the front lines.
Here’s what might help:
- See your GP as soon as you can. And keep going back. Not all GPs are familiar with reflux, and certainly not silent reflux. It will be harder to get a diagnosis when they’re not a puker. Persist until you get help. Then keep going back to get your meds adjusted as baby grows.
- Keep a diary. Then you can show the doctor how often you’re feeding, how much (if you’re bottle feeding) and how long they hollered for after a feed.
- Film your baby. I took videos of G Major’s bawling mouth and you can actually see the milk rise to the back of her throat and then drain away again. I showed this to the GP when they were umming and aahing about what it was.
- Drugs! You’ll probably initially be prescribed Gaviscon, which neutralises the stomach acid and forms a little blanket on to of the feed to help keep it down. You may then move on to ranitidine, which reduces the amount of stomach acid being produced. Beyond this, your GP can prescribe something like omeprazole, a proton pump inhibitor, which again inhibits the production of stomach acid. Make sure you give meds regularly – don’t just stop when you start to see an improvement.
- Propping baby up to sleep. You can put books under one end of the cot or a wedge pillow under the mattress to elevate baby’s head. At one point G Minor was sleeping almost upright – we made a nest in the moses basket out of a wedge cushion and a V cushion and dropped her down the hole.
- Get a sling. You will die without one. Baby is upright but can sleep on your chest. Parents have their hands free to do stuff. Plus, lovely snuggly baby time and they’re not screaming. Seriously, get a sling
- A dummy. This will create extra saliva to help sooth any burning in their throat
- Sleep in shifts. I used to go to bed at 7.30pm, just after supper. Big G would hold G Major and watch Breaking Bad, give a bottle of expressed milk at the late feed then go to bed at midnight. Then I’d be on duty for the rest of the night. That way I’d get at least five hours unbroken sleep, and Big G would get six or seven (depending how late he slept). We barely saw each other in the week for a few months but I kept my sanity.
- Ignore routines. If your baby has silent reflux, there’s no “putting them down sleepy after a feed” – they’ll scream the place down. Accept that you’ll be holding them in the dark for hours, charge up your kindle and phone, and settle in. You can still keep a bedtime routine of bath, feed, lullaby etc – G Major actually went to bed brilliantly after she grew out of the reflux.
- Get the hell out of the house. Baby will still cry after a feed but at least there are other people about. It’s miserable on your own. We went to at least one activity or group, sometimes two, every weekday.
Here’s what won’t:
- Co-sleeping, in and of itself. Baby will still be lying flat. If you want to co-sleep, all power to you, but just bringing baby into bed with you will not make it any better for you or them.
- Colief or Infacol. This isn’t gas. Or still-not-actually-defined colic. You need something to thicken the stomach contents and something to reduce the acid levels.
- Switching to formula. Again, go for it if it works better for you. It will be easier to share the load with your partner. And formula is slightly thicker than breast milk. But it’s still going to come back up. Keep breastfeeding if you want to – it’s not your milk, it’s their digestive tract.
- Eliminating dairy. Reflux is not CMPI; there is no evidence to suggest they’re linked. Baby will have issues with feeds whether or not you’re drinking soy or almond milk, and you’ll be sad because cheese. (Babies with CMPI might well be pukers, but it won’t be silent reflux.)
- Cranial osteopathy. Reflux occurs because the muscular valve at the end of baby’s esophagus, which acts to keep food in the stomach, hasn’t developed properly yet. No amount of pissing about with their skull will make that develop faster. That’s like suggesting cracking your knuckles will fix your pelvic floor.
Remember, hang in there. For most babies, silent reflux disappears between 12 and 16 weeks, and keeps improving as they sit up and wean. And the one advantage of silent reflux over normal reflux is that you’ve not had to deal with months of puking, keeping your clothes and soft furnishings intact.
Have you had a baby with silent reflux? What did you find helped?