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The basics of Silent Reflux in Babies

A popular misconception about silent reflux in babies is that babies who have it don’t cry. That’s an easy thing to misconstrue given it’s name, but it’s of course not true at all. The silent aspect of silent reflux actually has to do with the lack of spit up that comes out when babies have this kind of reflux. The stomach contents stay lower down in the digestive tract rather than coming all the way up and out as with regular reflux. The stomach acid and milk come up into the sensitive tissue of the esophagus where they can cause severe discomfort and potentially other more serious issues.

It’s common for silent reflux to go undiagnosed or misdiagnosed in young children. This is an ailment that affects adults as well, but adults can communicate their needs clearly. Babies can’t speak to us about what’s going on with their bodies. Their strongest method of communication is to cry for help, which only serves to indicate that something is wrong, not what is wrong. Silent reflux is painful and uncomfortable, which is why babies often cry when they are suffering from it.

The biggest issue with silent reflux, or laryngopharyngeal reflux (LPR) is that it’s difficult to uncover as there’s no visible vomiting as with other kinds of reflux. There are other signs that parents and doctors can cue into in order to tell that what’s going on is silent reflux that are less obvious but are nonetheless very much indicative of the underlying issue.

It all starts with understanding the causes of silent reflux, because without knowing what’s going on underneath it’s impossible to know what to do. Once the cause is known, then treatment can begin and that relief that your little one so desperately needs can come!

Here are five common causes for silent reflux in babies and what parents can do about it.

1. Mother’s diet

Cause: Bits of mom’s diet are contributing to silent reflux

Solution: Eliminate foods until the culprit or culprits of LPR are discovered.

For breastfed babies, the mother’s diet can be the most important trigger for silent reflux. Whatever mom is taking in is going to get transferred to the baby in some form or another. That’s why babies who suffer from silent reflux and are breastfed can be so deeply affected by their mother’s diet.

The most important thing for breastfeeding mother’s who are struggling with silent reflux in their babies is not to stop breastfeeding. You have to keep going! Switching from breastfeeding to formula at this point can cause even more problems. With the right actions, those foods that are causing the problem can be eliminated from mom’s diet and give relief to the child.

Here are some common triggers in mom’s diet that can cause silent reflux in babies.

· Soy Products

· Dairy

· Wheat

· Corn

· Chocolate

· Citrus

· Carbonation

· Alcohol

· Acidic foods

Eliminating the food or foods that you determine to be triggering the reflux generally only has to happen for a few months while the baby’s digestive system matures, and it’s well worth it to combat the symptoms of silent reflux in your little one.

The general idea is to eliminate everything on the list at first, then slowly add things back in until the culprit is discovered. Sometimes babies are just sensitive to one kind of food or another and need to have mom change up what she’s eating in order to accommodate their needs. It’s a small price to pay for a baby who is happier and healthier! Your little one can get all of the benefits of breastfeeding while also eliminating the silent reflux that causes so many issues.

2. The wrong bottle

Cause: The baby is swallowing too much air and/or eating too fast because of the wrong bottle.

Solution: Find a bottle that allows the baby to swallow less air and eat more slowly.

Of course it’s not just breastfed babies that have issues with silent reflux, babies who exclusively use formula can also suffer from silent reflux. There are decidedly different reasons that babies who use formula can suffer from silent reflux, but they are no less painful and challenging to deal with.

One of the first places to start is to look at the kind of bottle that’s being used to deliver the formula. You’ll find literally thousands of different bottles on the market for babies. The come in all shapes and sizes, with liners and without, and then with nipples that are formed in completely different ways. There is no one bottle that’s magical and will work with every child, however there’s something out there that will work with your little one.

Look for bottles that are specifically designed to keep the baby from swallowing too much air or gulping too fast, as these are issues can make reflux worse There are no bottles that have been proven through research to be better than others – it is unfortunately largely trial and error to see what works for your baby. Talk to other moms about what works for them, or to a feeding specialist who can really help.

If you thicken your child’s formula, you’ll have to accommodate with a nipple that has a wider hole in it. Some bottle systems come with nipples that are made for thickened formula, and some don’t. You may find yourself needing to invest in a whole new bottle system to accommodate the thicker mixture. Widening the nipples is a possibility, but it’s tricky and can be frustrating.

Finding the right bottle can be a big challenge, but it can also be pretty magical once you do, as for many formula fed babies with silent reflux getting the right bottle miraculously solves the problem.

3. Poor feeding position

Cause: Poor feeding position or positioning after eating causes milk to reflux back up into the esophagus.

Solution: Find a feeding position that works for your baby.

Babies who suffer from silent reflux can be incredibly sensitive to positioning, both during and after feeding. This actually makes a lot of sense, as the underlying issue with silent reflux is that stomach contents are coming back up out of the stomach against gravity.

Everything about feeding position with silent reflux has to do with moving to a more upright position to allow gravity to help food to stay down and in the stomach. Baby’s muscles aren’t as well developed and strong as are those in adults, and that includes even the muscles in the digestive tract. They grow stronger with time, which is a big reason that most babies with silent reflux grow out of the condition over time.

Whether you’re breastfeeding or bottle feeding, it’s possible to feed your child in a more upright position. Babies can be held with support for their upper back and head while having a bottle or breastfeeding. It’s also important to ensure that the neck isn’t crooked or curved in any way during feeding, as this can prevent gas bubbles from escaping, causing turmoil in baby’s tummy. Think about keeping the entire digestive system from the mouth down to the stomach in one straight line during feeding.

This advice about silent reflux in babies also goes for the time directly after feeding when positioning is just as important. Gently walking with the baby upright and leaning against the caregiver’s shoulder encourages stomach contents to stay down and can be a very effective relief technique for silent reflux.

It’s important to note that in order to prevent sudden infant death syndrome (SIDS), always put your baby to sleep on their back. Young infants don’t have the muscle tone to roll over to breathe, and doctors recommend that babies NEVER be put on their front to sleep as it increases the likelihood that they’ll suffer from SIDS. Babies with silent reflux might be more comfortable on their bellies, but it’s only safe if they’re being held by a caregiver and they should never be left unsupervised this way.

Photo credit: Vincent_AF via / CC BY-SA

4. Allergies

Cause: Allergens in the diet trigger stomach upset, which causes silent reflux.

Solution: Uncover and eliminate allergens

One of the biggest causes of silent reflux in babies is allergies. Addressing possible allergies will help you to uncover the root cause of reflux in your child and then to address it effectively. Perhaps the most common allergy associated with reflux in babies is dairy. Up to one third of babies have a dairy allergy, though most outgrow it as they pass through toddlerhood. There are all sorts of other allergens out there as well, and some children won’t ever grow out of them entirely.

Unlike other kids of allergies, there are no tests to find out if a food is going to cause a gastrointestinal reaction. The only way to uncover what’s causing the reaction is to eliminate foods until symptoms subside. It’s all trial and error! Always consult with your child’s pediatrician before starting an elimination diet.

Babies have to ingest a LOT of calories in order to gain weight and keep growing. This is important for brain development and all kinds of skills down the line. What happens now will affect your child in twenty or fifty years. That’s a lot of pressure, but it’s just that important!

A doctor can help you to make sure that your child is getting enough calories while you’re trying to determine what the underlying cause is. This way you can work to address the allergy while also helping your child to gain weight the way that’s needed to be healthy. Nutritional deficiencies can cause fatigue and cognitive issues in both breastfeeding mothers and in their babies, which is why breastfeeding moms must look out for eliminating too much from their diets in their quest to halt silent reflux. Formula fed babies should never be given rice, oat, or nut milks. In fact, babies under a year old should never be given anything except for formula that’s been created especially for babies. Soy based formula and dairy formula are the only two options for formula on the market.

5. Teething

Cause: New teeth coming in cause crying, discomfort, and swelling that leads to gastrointestinal issues and silent reflux.

Solution: Provide relief for sore teething gums to combat silent reflux.

Teething is a natural part of being a baby, but at the same time it’s can be a serious challenge. Many parents report that their children start to show symptoms of acid reflux around the same time they start teething, leading it to be often cited as a cause for teething. Teething can either cause silent reflux to get worse in babies who already have it or can even bring on the issue in babies that don’t have silent reflux.

Around six months of age is typical for babies to start teething, but it can start well before that or long after for an individual child. There is no right age to start teething, and it generally lasts until about three years of age. Unfortunately, some babies have reflux flair ups when they’re teething all the way through the process. Luckily there are some things you can do to help.

Using over the counter medications for teething can be incredibly helpful for babies. Be careful as some common medications can actually exacerbate the issue and make stomach upset worse, which contributes to worsening reflux. Numbing creams are much the same – they can be very effective but watch out that they aren’t making the issue worse. You can’t go wrong with cool (but not frozen) teething toys, which numb the gums naturally.

Photo credit: xlordashx via / CC BY

No matter what the cause of silent reflux in your baby is, there are always things that you can do to help your child. Always consult with your child’s doctor if you believe that they might have a medical condition like silent reflux.

Want to know more about silent reflux in infants?

  • Checkout our eBook titled: “Silent Reflux in Babies - Diagnosis, Treatment, and Coping for Families.”.  Inside you’ll find all the information you need to help your little one get the help he or she needs, including complications to watch out for, how to talk to your child’s doctor, coping strategies, and so much more.

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“The 5 Common Causes and Solutions for Silent Reflux in Babies”

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