One of the hardest aspects of caring for a baby or child with Gastroesophageal Reflux Disease (GERD) is dealing with the sleep issues. Unfortunately, the vast majority of infants and toddlers with reflux experience difficulty going to sleep or staying asleep. Parents report that they need to hold and rock the baby, swaddle and offer a feeding or a pacifier to settle their infant or toddler for the night. Only the sleep doesn't last long and often the night is filled with restless sleep, crying out, and frequent waking for comforting and feeding. It is enough to cause an otherwise happy and healthy adult to question their ability to cope.
It is interesting to note that sleep issues affect infants and adults with reflux. A Gallup Poll conducted a while ago indicated that the majority of adults with GERD listed sleep issues as the top quality of life issue they faced. Poor sleep from GERD affected their concentration during the day, job performance and more. I always tell parents that reflux is a 24 hour disease and sleep problems are common no matter how old you are. The only real difference is adults can report their concerns to the doctor or fill out surveys and infants need to cry and fuss to tell the story. But don't lose hope. At some point, your baby will sleep for longer stretches at a time and eventually you will both get through the entire night. Let's start with the basic on helping your baby to get to sleep and stay asleep. In another blog, I will address the issue of managing sleep problems that persist much longer and how to cope with long term sleep issues.
The Reflux Mom's Tips for Helping Your Baby Sleep at Nighain Management:
It is important to work with the doctor to decrease the pain associated with GERD.
Other Health Issues:
There are so many reasons babies wake up at night that I am sure this list will miss an important cause of night walking. In general, night waking may be caused by reflux or something else entirely such as an illness (but especially a cold or respiratory illness), fever, cough, asthma, constipation, teething or an ear infection.
Elevate the Sleep Surface:
Many infants with reflux benefit from elevating the sleep surface. Be sure to ask your doctor if your infant needs a wedge for sleeping.
Look at the Diet:
Try to limit intake before bedtime. A full stomach and reclined sleeping may cause more backwashing. Talk to the doctor about managing reflux by changing the diet since food allergies and intolerances may make sleep uncomfortable.
Set the Tone:
An infant may benefit from swaddling, rocking and a quiet, dark room to set the tone for sleeping. Make sure the room isn't too hot or too cold by adjusting the room temperature, blankets and clothing.
Guide her to Self Soothing:
It is always a good idea to help an infant find ways to soothe herself by sucking on a pacifier, stroking a soft stuffed toy or holding a blanket. It may take weeks or months to help a baby to settle down for sleep if reflux has caused prolonged discomfort with little opportunities to learn how to self sooth. Remember she has to learn a new way of going to sleep so take small steps toward success.
Calming the Baby by the Book:
There are several excellent books about helping a baby settle for sleeping including: Secrets of the Baby Whisperer by Tracy Hoggs and The Happiest Baby on the Block by Harvey Karp, M.D. I must say that I get a little nervous about the cry it out methods advocated by some books. I know of many success stories with these methods. However, when I tried this method with my refluxer she cried long and hard before vomiting all over herself and her crib. There is nothing worse than finding your infant covered in dried vomit after a "let her cry it out" session.
Co sleeping is common in other cultures and many parents report that babies (and parents) sleep better when they are co sleeping. The American Academy of Pediatrics recommends using a co sleeper crib with a separate sleep surface that attaches to the bed.
Check Your Stress Level:
Babies are very smart and even a young infant can tune into a parent's stress. Certainly frequent night waking is stressful and exhausting. So check your emotions at the bedroom door. If you are going to convey frustration and tense muscles, see if you can enlist some assistance from your spouse or another family member so you are not always in charge of the night shift.
Wishing you and your little one some rest!