Medicated suspected reflux and baby sleep

Reflux is characterised by frequent large spilling up of milk after a feed.

This is attributed to a baby having an immature digestive system where the oesophageal sphincter does not close properly after a feed resulting in spilling.

Due to this some spilling is normal for babies and most cope fine, others spill excessively and do not cope with stomach acid causing irritation and pain to the oesophagus. Silent reflux (without spilling) is a little harder to accurately pinpoint- and is often attributed to persistent screaming, alongside back arching and distress for baby when laid down.
In recent years the number of infants being medicated for suspected reflux has increased significantly.

As a sleep consultant, I have recently worked with a number of families with infants on medication (losec/omeprazole) for suspected silent reflux.

The diagnosis of this was determined following baby being difficult to settle, appearing to dislike being laid down for sleep, and persistent screaming only being calm when held upright.

A lot of these are symptoms we notice in babies and sometimes toddlers who are overtired, and have not been able to settle themselves to sleep without a lot of parental intervention. In most cases, these sleep habits have continued on in babies who are medicated for reflux.

A significant effect of Omeprazole and similar medications, is that in long term use it inhibits absorption of magnesium in gut. Magnesium plays a huge role in assisting babies and toddler’s (even adults!) to sleep.

This mineral plays a vital role in muscle relaxation and the deactivation of stress hormones, essentially helps us wind down and calm to transition to sleep.

Long term, use of anti-reflux medication can cause deficiencies in magnesium, and studies show even small deficiencies can lead to symptoms of nervousness, and difficulty winding down. Make sure you chat to your Doctor about getting your baby or toddler off losec when the time is right.

So what if you suspect your baby has reflux, and you are seeking medical advice and considering medication?

Well firstly there are a few things that can help as well as seeking advice around medication:

1. Have a review of baby’s and your temperament- is your baby more sensitive to stimulation? Do they get very wound up quickly? Are you yourself fretful and worried when your baby cries? These kinds of babies can benefit from a very short awake window, and a very long wind down before naps.

2. Review baby’s daily activity and sleep environment- is their room brightly lit and full of stimulating objects like toys and mobiles? Have they been up for some time and overtired when going to bed, fretting when you put them down fighting sleep? Read this blog on over tiredness to help with refluz symptoms.

3. Do you struggle to settle your baby? Feeding to sleep can be what some reflux babies want to help soothe their sore throats, but sometimes the feeding right before a nap makes the reflux worse. Reflux babies often respond to a dummy/pacifier it helps in the same way as feeding. Holding baby upright before a nap and after a feed can help ensure baby doesn’t experience pain while sleeping.

4. If you answer yes to a few of these factors above, it might be worth taking some time to address sleep habits and work on these for a couple of weeks to see if things improve in conjunction with working with your babies Doctor to see if they need any medication.

5. If the symptoms continue after addressing sleep habits for baby, and medication, it might be worth chatting to your Doctor about the possibility of a cows milk protein allergy or intolerance.

Sophie Lloyd, infant and child sleep consultant, sleep educator and registered nurse.

Often when a baby is suffering from reflux, sleep habits don’t develop as well as they could if baby wasn’t in pain. This can mean once you have sorted out the pain factor you are left with a baby who wakes frequently, takes short naps, and needs to be fully assisted to sleep.

Once your reflux baby reaches 5-6 months, it is a good age to start working on healthy sleep habits and consolidated sleep.

If you would like some support and help with this from an experienced sleep consultant, check out our packages below.