Reflux in baby sleep coaching & sleep training

This blog series will explore a topic that will sadly strike a chord with many parents - the topic of reflux, CMPA (cows milk protein allergy) and lactose intolerance and how gentle, holistic sleep coaching can actually work for babies that suffer from any of these conditions.

Part 1 covers reflux, and how responsive, gentle & holistic sleep coaching or sleep training will help your family get better sleep.

Babies with reflux are understandably uncomfortable after feeds. This can make may parents feel like there's no point in starting sleep coaching at all, or giving up if they've already started. However, with the guidance of a sleep expert who is trained in working with families and babies with reflux can transform sleep for the entire family. In this blog, I'll discuss the causes, signs and symptoms of reflux and how to get better sleep.

What is reflux?

Reflux in babies, also known as gastro-oesophageal reflux (GER), occurs when the contents of the stomach flow back into the oesophagus. This common condition is typically considered normal in infants, especially during the first few months of life, as their digestive systems are still developing. Several factors contribute to reflux in babies:

• ‍Immature Lower Oesophageal Sphincter (LES): The LES is a ring of muscle that separates the oesophagus from the stomach and acts as a valve to prevent stomach contents from flowing back into the oesophagus. In infants, this muscle is not fully developed, making it more prone to allowing stomach contents to regurgitate. Regurgitation and excessive fussiness/crying that goes beyond colic are considered the main symptoms of reflux.‍
• Lying Flat: Babies spend a significant amount of time lying down, whether during sleep or while feeding. In this position, gravity has less influence on keeping stomach contents down, making it easier for them to flow back into the oesophagus. Evolutionary wise, babies were never left flat, as it made them easier prey for predators. So babies evolved being carried upright and predominantly contact napping, as opposed to today, where they are in prams/cots etc for a large part of their day.‍
• Liquid Diet: Babies primarily consume a liquid diet, either breast milk or formula, which is more easily regurgitated compared to solid food. The composition of breast milk, which is thinner than formula, may also contribute to more frequent regurgitation.‍
• Small Stomach Capacity: The size of a baby's stomach is relatively small, and they may consume smaller, more frequent meals. This can result in a higher likelihood of stomach contents being brought back up.‍
• Muscle Coordination Development: The coordination between different muscles involved in digestion, including those in the oesophagus and stomach, is still developing in infants. This can contribute to temporary inefficiencies in the digestive process.‍
• Food Sensitivities or Allergies: In some cases, reflux may be associated with food sensitivities or allergies. For example, Cow's Milk Protein Allergy (CMPA) can cause digestive discomfort and reflux in infants.

While reflux is a common occurrence in babies, it's essential for parents to differentiate between typical reflux and gastro-oesophageal reflux disease (GERD). GERD involves more severe and persistent symptoms, such as excessive irritability, poor weight gain, and difficulty feeding, and may require medical attention.

If you are concerned about your baby's reflux or if they are showing symptoms that cause distress, it is advisable to consult with a healthcare professional for a clinical evaluation and guidance on management.

Reflux and night time

Parents of little ones struggling with reflux often encounter the difficulties of night feeds. Reflux can really disrupt traditional feeding and sleeping routines, interrupting the night's sleep. Enter reverse cycling, a phenomenon where babies develop a preference for night time feeds over daytime feeds. This is often because they are 'dream feeding' at night so aren't experiencing the discomfort they have during the day. A baby sleep expert can really help and guide in this situation, offering strategies to navigate these challenges while ensuring that the night time needs of the baby are met.

Tackling reflux

A cornerstone of gentle sleep coaching involves addressing reflux, recognising its impact on baby sleep. Practical strategies, such as elevating the head of the crib (adhering to safe sleep guidance, so only when a carer is present in the room) and mindful feeding practices, like 'paced feeding' can help to alleviate the symptoms of reflux. A certified, qualified sleep coach or sleep trainer, well-versed in helping families get better sleep as well as training and experience in baby reflux, can provide tailored advice to seamlessly integrate techniques to help relieve reflux into a gentle, holistic sleep coaching plan.

Why holistic sleep coaching can help with reflux:

Holistic sleep coaching's focus extends beyond just wake windows and sleep routines to encompass the overall well-being of your little one. By addressing reflux,  with knowledge, experience, compassion and insight, an environment which encourages good sleep which encourages optimal growth and development is created. Every aspect of your child's life and environment is taken into account when creating a plan and support package, meaning it is more likely to succeed than more traditional styles of sleep coaching or sleep training.

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