Unidentified food sensitivities or reflux? Determining the reasons for a colicky baby.
Question: Is reflux a real thing or is it unidentifiable food sensitivities? My babe had horrible reflux and I did eliminate diet and now she’s great!
Answer: Back in 1992, with the first edition of The Baby Book, we clarified what was called at that time “colic confusion”. There was even a saying: “Colic is a five-letter word meaning the doctor doesn’t know why my baby hurts.” Instead of the label “colicky baby,” we called it “the hurting baby,” which motivates the parents and the doctor to keep searching for the reason why the baby hurts. We found that the two medical causes of the hurting baby were reflux (also called gastroesophageal reflux disease) and food sensitivities, mainly to wheat and dairy in mom’s diet.
Clues That it is Reflux
Frequent bursts of painful cries, unlike the usual baby cry; excessive spitting up after eating; bursts of night-waking in pain; less crying when carried upright; frequent sour burps and throaty noises.
Diagnostic and Treatment Regimen
When we see a baby with several of these signs, we encourage parents to start this diagnostic and treatment regimen:
- Give baby high-touch, in-arms parenting.
- Wear baby semi-upright in a baby sling or carrier for at least 30 minutes after feeding – gravity helps decrease reflux.
- Keep baby quiet for at least 30 minutes after feeding, not bouncing, as this causes stomach contents to reflux up into the esophagus.
- Follow Dr. Bill’s “Rules of Reflux Feeding:” feed half as much, twice as often. Besides decreasing reflux, frequent feeding stimulates more saliva, which helps heal and lubricate the acid-irritated lining of the esophagus.
- Burp baby well when switching from one breast to the other, or after a few ounces of a bottle.
Breastfeed baby: breastmilk is appropriately called the “easy-in, easy-out food” because it empties from the stomach quicker than formula.
- If the doctor still suspects reflux, but none of the above are helping, the diagnosis can be confirmed by esophagoscopy. If reflux has been ruled out, then eliminate wheat and dairy (and perhaps other foods) from your diet if breastfeeding. See elimination diet link, here. Or if formula feeding, the doctor will recommend a hypo-allergenic formula.
The good news is that both reflux and food sensitivities tend to lessen by 6 months of age when the intestines are more mature and baby is more upright. If it persists, the doctor may suggest an antacid medication for a short time.
Martha Sears, RN