What is Reflux?
Reflux refers to the ‘spit up’ or vomiting, after a baby has fed. The reflux is a combination of milk, and stomach acid, which pushes back up from the stomach, into the oesophagus (food pipe). This is commonly referred to as GER (Gastro oesophageal reflux).
In some instances, the milk/acid mixture, will not reach the babies mouth, or baby will swallow the reflux, in which case, there is little to no vomit or spit up, this is called ‘silent reflux’.
GER is normal in most babies, as the oesophageal sphincter and babies immature gut, needs time to mature. Most babies have no ill effects from reflux, and will outgrow it by 1 year of age.
Frequent and severe reflux, GERD (Gastro oesophageal reflux disease), can cause ill effects in some babies, affecting their sleep, mood, feeds and weight gain. Symptoms (and when to consult a doctor) include:
• Fussy baby, crying during or after feeds
• Frequent reflux and or vomiting (not with silent reflux)
• Difficulty sleeping, especially when lying down
• Frequent hiccough and/or cough
• Failure to thrive
• Cramps, gas and colic
• Sour breath or burps
• Refusing breast or bottle
• Arching of back
• Brining up green, yellow or dark brown vomit (that looks like ground coffee)
Treatment OPTIONS available for reflux
Homeopathy refers to a system of medicine, that uses ultra dilutions of substances, to treat illnesses. A prescription is based on ‘likes cures likes’, so if a substance can cause a specific symptom picture in a large dose, then it can heal it in an ultra diluted form. So each baby and each symptom picture is unique.
Homeopathic single remedies that are often used in the treatment of GORD include:
• Hyocymus 200: Reflux associated with hiccoughs.
• Asafoetida 200: Reflux linked with induction, epidural or forceps.
• Lobelia inflate 200: Reflux linked to family smoking.
• Lycopodium 200: Winy babies with a lot of gas. Worse between 3 pm- 5 pm.
• Aethusa cynapium 200: Family history of lactose intolerance. Baby regurgitates everything, often projectile vomiting after every feed.
Homeopathic Complexes Include:
• Magen, Sedaped and Cesranol from Natura
• Sister Lillian’s NausiCare
• Gastric plus 30 C from Pegasus.
2. Chiropractic Treatment:
Chiropractics is a system of medicine, focussed on the wellbeing of the individual, placing special attention on the neuromuscular system, and treatment is focussed on manual adjustments of the spine.
A chiropractor can identify areas of subluxation of the spine (malalignment), which is especially true in C section or forceps births. By manually adjusting these areas, the nerves existing in this area, can function optimally. In the instance of the digestive tract, nerve flow correction to the digestive tract, can enhance digestive function.
3. Cranio-Sacral Therapy (CST):
Refers to correcting any imbalances in the craniosacral system, which includes the membranes and cerebrospinal fluid that surrounds and protects the brain and spinal cord. Imbalances in this system, can cause sensory, motor and or neurological disabilities. For this reason, the health of the digestive tract, can be enhanced through CST.
4. Position during feeds:
It is important to feed your baby in an upright position, to prevent the back flow of milk and stomach acid from the stomach into the oesophagus. After a feed, you should keep your baby in an upright position for at least 20 – 30 minutes. Also, try and burp baby every 2-3 minutes during a feed.
5. Sleeping position:
When lying baby down for a nap, consider keeping baby elevated, using an anti-reflux wedge, found at Baby City and other major retailers. This will help prevent the back flow due to gravity
6. Breast Milk:
Breast is best. If you are breast feeding, try to ensure, that baby only feeds on one breast at a time. This is to ensure, baby does not only finish the watery foremilk, but also reaches the full fat creamier hindmilk. Smaller feeds will also help prevent excessive reflux.
There are various formulas out there, that can aid in alleviating acid reflux in babies. These include the thicker anti regurgitation formulas (AR), such as NAN and Novalc AR (there are many more brands, consult your homeopath or paediatrician, to choose the formula best indicated for your baby). Also, in the case of a lactose intolerance, there are hypoallergenic, extensively hydrolysed (HA) formulas, which may also alleviate reflux in lactose intolerant babies.
8. Mothers diet:
It is important for mom, to eliminate any foods that might aggravate the acid reflux in baby. First and foremost, diary, gluten, coffee and sugar in any form. From here, if the reflux does not improve, mom can consider an elimination diet, restricting her diet to only good sources of protein (not diary or nuts), vegetables (non cruciferous and non gaseous causing veggies only) and non-glutinous grains. After there is an improvement, she can start reintroducing one food group at a time. If there is no aggravation, another food may be introduced every three days. Dairy, sugar and gluten however, are best avoided in the long run.
A good probiotic is essential. Ask your homeopath or paediatrician for a trusted brand. A good probiotic, loaded prebiotics (the food probiotics need to grow) can help restore the gut flora, aiding in the regulation of stomach acid production. You can add this to your own diet, and to babies bottle every day.
10. Tissue Salts:
Never underestimate the value of tissue salts, in the treatment of gastric disturbances in babies. Nat Phos tissue salt, is an acid regulator. The most commonly used anti spasmodic tissue salt, Mag Phos, can be given on its own, or in combination with other tissue salts, which can serve as a colic mixture. These tissue salts include, Mag Phos, Ferrum Phos, Calc Phos, Nat Mur, Nat Phos and Nat Sulph. You can combine the above mentioned tissue salts in even ratios, and pulverise using a blender or two large spoons. Use less than 1/8th of a teaspoon before and after feeds. You can either apply the powder to the tip of baby’s tongue, or you can use a drop of cooled boiled water, to form a paste, then apply to the tip of baby’s tongue. Mom is also welcome, to use this mixture, as baby will get the tissue salts in moms breastmilk.
There are no easy answers, in the treatment of GER or GERD. Mostly, it is variations of a combination of therapies, supplements dietary and lifestyle advice, which can ultimately offer some relief for you and baby. Please always take your baby to a homeopath or paediatrician, if you see signs of dehydration, malnutrition, failure to meet milestones, if baby is not gaining weight, inconsolable crying, baby that refuses to feed and blood (bright or dark coloured blood that looks like coffee grounds) in babies vomit or stool.
Mommies. You are amazing, and you are doing an amazing job. No one ever warned you how difficult it is, to be a first time mom, and a reflux baby certainly adds to the sleep deprivation. You are not alone, you are every mom out there, either they have been there, or they are currently there. Always ask for help if you are not coping. It does not make you a bad mother, it makes you human. You are ultimately, what is best for baby, so if you are not ok, baby is not ok. So take a time out. Get dad to babysit, or ask your mom to come over so you can have a nap (and let her bring dinner too… the dairy free, gluten free, sugar free, non cruciferous vegetables type). This too shall pass, and then you have something to hold your kids to, for the rest of their lives.
Dr. Marike de Klerk