Silent Reflux
our experience with silent reflux
Let’s talk about silent reflux and how it differs from GERD or traditional reflux. I’ve found that silent reflux isn’t something often talked about in the baby sphere. It’s something we went through with our daughter Nora and I just remember feeling like I know something is wrong, but not being able to necessarily figure it out. Nora’s symptoms were being very fussy around the clock, not sleeping well, not wanting to feed, but when she would feed she’d be arching her back, turning red, and going rigid. So we knew something was up. We met with three different lactation consultants to rule out issues with latch, oversupply, or forceful letdown. We made sure she didn’t have either a dairy or soy allergy. Finally, I got our pediatrician to watch her try to eat and they finally referred us to a GI specialist after seeing first hand how upsetting it was to her (and me!) to try to eat. The specialist was able to run some tests and get her on medication that helped tremendously.
I remember being so overwhelmed and frustrated during that time. We knew something wasn’t right with the way Nora was feeding and behaving- she was up all night and refusing to eat, but every doctor visit we would leave with no answers. It was really hard to have a colic newborn who didn’t want to eat or sleep. I also remember feeling relieved when we finally had answers.
silent reflux vs. GERD
Silent reflux is reflux, but without the spitting up, or not as much of the spitting up as is typically associated with reflux in babies. When we think of reflux babies or GERD babies, we think of them spewing all of the time. With silent reflux they're not necessarily doing that, instead they just have all the other symptoms- the fussiness, the colic, aversion to feedings. So it still presents as reflux without the most common symptom (spit up), making it harder to diagnose.
All babies are born with an immature esophageal sphincter. The esophageal sphincter is like a little door at the end of the esophagus that allows food to pass into the stomach, then closes tightly once it passes. Baby’s sphincter is not mature yet, so it's extra floppy. Then we're feeding them a liquid diet with milk or formula and we're laying them flat all the time. Those three things aren't really working in their favor as far as preventing spit up. Therefore most babies reflux to a certain extent, but there's a difference between just refluxing and GERD. GERD a is gastroesophageal disease where the stomach contents are coming up along with a lot of acid. It can cause some other symptoms- aversion to feeds, failure to thrive. It is really painful to the baby. So what happens with babies who have silent reflux is they're having the action of reflexing, where the stomach contents start coming up into the esophagus, but instead of forcefully spewing out of the mouth- it comes up the stomach, even creeping up into the back of the throat and then get swallowed back down. This causes a lot of pain, along with the symptoms of fussiness, colic, and sometimes some babies will kind of choke on it. I also remember Nora had a really acidic smell on her breath. Some people may be thinking, “Okay, big deal. They reflux the contents up and swallow it back down. There we go.”, but that's not necessarily the case. They still have the pain of that acid coming up their throat.
I think a lot of us can relate. I remember when I was pregnant and experiencing heartburn and how much pain I had in my chest, throat, neck, and even sometimes in my back- and I think it’s important to empathize with our baby and understand how badly that can hurt and how uncomfortable that can feel. On top of that, they can’t voice exactly what hurts and what’s bothering them, so of course they’re more fussy and not wanting to eat.
treatment
When Nora was flat out refusing any type of feedings, we knew she needed more specialized help. We were then sent to the GI clinic and they ran some tests and ended up putting her on medication. I can honestly say we tried everything before deciding to use medication- we met with lactation consultants, we made sure it wasn't an allergy issue. They just kept saying she’s fine, when it was so obvious to me she wasn’t. When the GI doctor said we could start her on medication to help, I felt relieved. I know not every issue is solvable with medication. It’s important to try those other methods first if that’s what you want to do. There are so many avenues to working through different issues or journeys with our children. I just don't think there should be shame or judgement around medicine when it’s needed and necessary. Some babies with silent reflux may not need medicine- maybe they need an adjustment of feeding/ positioning/ flow, but when those avenues are exhausted, it’s okay to do what you feel is best for yourself and your child. Sending love if silent reflux is something you’re struggling with right now!!
