Reflux in babies can dramatically affect their ability to fall asleep and stay asleep. It will also affect Mom’s confidence in how well her baby can sleep which can increase parental interventions at bedtime which can lead to more night waking. Meaning the more you have to help out at bedtime to get your baby to sleep, the more help you’ll have to continue to deliver in the nighttime.
The drive to sleep is biological, but the way we sleep is a learned habit. All humans wake in the night. Babies who were held, fed, or rocked to sleep at bedtime, will ask for this same help when they surface from sleep in the night. To be an independent sleeper, go down without help, and sleep 11 + hours through the night, your child needs to be at least 4 months of age and have this important skill.
Symptoms
Reflux in babies can present in many different manners. Reflux exists on a continuum. Meaning the symptoms may vary in severity from child to child.
Many kids are “happy spitters.” They spit up but it doesn’t seem to bother them. They show no signs of pain or distress.
According to the American Academy of Pediatrics (AAP), the more serious form of reflux is gastroesophageal reflux disease GERD.
The AAP describes the symptoms of GERD as the following:
- Refusal to feed
- Crying and/or arching the back during feeds (i.e., seems to be in pain)
- Blood or greenish color in the spit-up
- Increase in frequency or intensity of the spit-up (i.e., forceful)
- Belly is swollen or distended or feels hard
- Respiratory symptoms—including wheezing and coughing
Silent Reflux
I am not an expert on reflux. My child had “silent reflux” where the stomach contents escape through a weak esophageal sphincter and splash up into the esophagus or “food tube.” Once the contents are in his mouth he swallowed them back down. He would grimace when this would happen. In the morning when I picked him up from his crib he often had wet spots on the mattress around his head. In the night he would turn in his head and spit the reflux out. But he didn’t cry out or need my help falling back asleep. Even though he would wake in the night with reflux, he knew how to relax back down into sleep. His reflux wasn’t excruciating and he had the learned skill of falling asleep independently. The learned skill.
I have worked with many, many babies with reflux that varied from mild to severe. Babies with reflux will need more comfort and care than other babies. They may also sleep through the night later than most kids because of the variable of reflux. This doesn’t mean they will always be terrible sleepers. They just need more time to get the reflux under control.
Why Your Reflux Baby Struggles With Sleep
- She’s gassy. I’ve found that babies with reflux often can be challenging to burp. The feeling of needing to burp can cause them to take short naps or wake more frequently in the night.
- She feels pain. The acid splashes up into her esophagus and she wakes up because of it.
- For babies over 4 months, over time you’ve held her upright to fall asleep, and she’s associated that falling asleep looks like being held upright. So when she wakes in the night, as all humans do, she wants/needs to be held to fall back asleep.
- For older babies, you’ve now got a little PTSD. Those first few months with a baby who has reflux are so stressful. She’s been in pain or uncomfortable and now you’re programmed to jump at the slightest toot. Your worry meter is super sensitive.
- Because of the stress you’ve been through, you have doubt that she’s capable of sleeping long age-appropriate stretches.
If you’re struggling with reflux and lack of sleep, the first thing you need to do is get the reflux under control. Contact your pediatrician to discuss your options.
3 Tips to Help Your Baby with Reflux Sleep
- For breastfeeding Moms, a food diary can help. Can you notice a correlation between any foods you eat and increased reflux symptoms? Personally, I noticed that caffeinated things and sugary things bothered my son more. Every child is different.
- Work on moving feeding away from sleep so that her stomach isn’t full when she’s laid down, which puts more pressure on the esophagus and can aggravate the reflux.
- Timing of sleep. You can download my sleep timing chart which outlines how long your baby can comfortably stay awake between naps and bedtime by monthly age.
Summary
You can have a “good sleeper.” Don’t lose hope. You first need to get your baby out of pain and diminished signs of reflux before you can completely tackle sleep and have your 4 months and older baby sleeping through the night for 11+ hours. While you work on the reflux, consider foods that might aggravate it, moving feeding away from sleeping and timing of sleep.
Once the reflux is under control and you’re ready to get to the stage where you can put your little one down completely awake without any rocking, bouncing, or feeding as part of your routine take a look at my free discovery call. There’s nothing like having a sleep expert with experience helping parents of babies with reflux guide you through the process.
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Sending sleepy vibes and sweet dreams your way!
Erin McCormick
Your Pediatric Sleep Specialist
