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Is Your Baby Suffering from Silent Reflux? Recognising the Signs

Welcoming a new baby into your life is an exhilarating experience. As a parent, you’re prepared for sleepless nights, diaper changes, and endless cuddles. However, when your little one starts showing signs of discomfort during or after feeds, it can leave you feeling concerned and puzzled. 

One possibility to consider is silent reflux, a condition that often goes unnoticed, but can cause significant distress to both infants and parents. 

In this blog, we’ll explore what silent reflux is, it’s common symptoms, potential causes, and most importantly, how you can manage it with my top 5 tips to ensure your baby is comfortable and thriving.

What is Silent Reflux? 

Silent reflux is a medical condition in which stomach contents, including stomach acid, flow backward into the baby’s throat and sometimes even up into their nasal passages. Unlike regular reflux, silent reflux does not typically result in spitting up, making it difficult to diagnose. 

More than half of babies with reflux spit up, but there’s no discomfort or pain, and they do it with little effort. In case of silent reflux, babies can really be in pain and discomfort as the food travels back up the food pipe but is swallowed rather than spat up. So, they can feel a burning feeling. 

Common Symptoms of Silent Reflux

The challenge with silent reflux is that it often mimics other common baby issues and can be mistaken for colic or gas. However, some key signs and symptoms might indicate silent reflux in your baby: 

  • Fussiness or frequent irritability: Your baby may seem unusually fussy, irritable or unhappy, especially during or after feeds. 
  • Difficulty swallowing: You might notice your baby swallowing or gulping frequently, as if trying to clear something from their throat. 
  • Arching of the back: Possibly to alleviate discomfort.
  • Coughing, gagging or choking during or after feeds. 
  • Poor feeding habits: They can refuse to feed or pull away from the breast or bottle very often, resulting in not gaining weight properly. 
  • Breathing issues: Including wheezing or congestion, as stomach acid irritates the baby’s airways. 
  • Poor sleep patterns: Sleep disturbances, including frequent waking, restlessness, and difficulty falling asleep. 

As you can see, some of the symptoms coincidence with regular reflux, as we discussed in this older blog, but others are more specific to silent one. 

Causes of Silent Reflux

Understanding the potential causes of silent reflux can help you manage and alleviate the conditions more effectively: 

  • Underdeveloped Lower Oesophageal Sphincter (LOS): In many cases, silent reflux occurs due to an immature or weak LOS. This muscular ring between the oesophagus and stomach is responsible for keeping stomach contents from flowing back up.
  • Food sensitivities or allergies: Some babies may be sensitive or allergic to certain foods in their mother’s breast milk or formula, leading to increased acid production and reflux symptoms. The most common are proteins in dairy, soy, and eggs producing a cow’s milk allergy or lactose intolerance. 

My Top 5 Tips to Manage Silent Reflux in Babies

There are different ways to treat your baby if they’re suffering from silent reflux. Sometimes the symptoms are manageable with some simple changes in your diet, but sometimes medical intervention is needed. So, if you suspect that your baby is suffering from silent reflux, it’s essential to consult with a paediatrician for proper diagnosis and guidance. The following strategies may help alleviate symptoms: 

1. Smaller and more frequent feeds: Aim to feed your baby more often, so they get a smaller amount of milk. Bigger amounts can increase abdominal pressure, which worsens reflux symptoms.

2. Overfeeding or feeding too quickly: As mentioned in this other blog, using the “Kassing” or paced bottle feeding method is the most physiological way to give a bottle because it allows your baby to take the milk respecting their rhythm and optimizing the intake amount. 

3. Thickened feeds: Sometimes it does not make any difference, but it’s recommended thickening breast milk or formula to help the milk to not come up. 

4. Avoid trigger foods: As mentioned before, an intolerance or allergy might be causing the reflux, so my first recommendation is to write down what you eat every day and observe how your baby behaves. If they feel worse with some foods, consider eliminating common trigger foods like dairy, soy, eggs, or the food you might think is causing them more issues. 

5. Medical treatment: In severe cases, a paediatrician may recommend medication like omeprazole to reduce stomach acid production.

In conclusion, silent reflux can be a challenging and uncomfortable experience for both babies and parents. Recognising the symptoms and seeking professional guidance is crucial to help your baby find relief. 

Remember that every baby is unique, and what works for one may not work for another. Sometimes we ask for quick answers, and with silent reflux, we need to be a bit patient because it’s not easy to diagnose. My best recommendation is to consult a lactation consultant IBCLC to develop a tailored plan for managing your baby’s silent reflux, and to follow the necessary steps so your little one can grow and thrive comfortably. 

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