The silent pain of Silent Reflux

Silent reflux is a very real problem in babies. It can be incredibly painful and distressing – both for babies and for parents. I know, because I lived with it with all three of my daughters.

Different to reflux or colic where babies tend to vomit or spit up small amounts of milk and saliva, ‘Silent’ Reflux means it’s very difficult for them to spit up or burp at all. In fact the acidic reflux from the stomach can burn both up and down the oesophagus, meaning the pain is even more intense than reflux.

The way my Paediatrician explained it was that it’s basically like constant indigestion for newborns. And if you’ve ever had indigestion you’ll know how uncomfortable and painful that is. You may find that your baby sounds like they have reflux, or are about to spit up with a wet sounding burp, but then nothing comes out.

It makes feeding very painful for the baby, and difficult for the parents which is very distressing – particularly breastfeeding mothers.

It’s incredibly hard to diagnose; I only realised my second and third babies had it after the traumatic experience I had with my first daughter. I knew the signs, and knew to get onto it right away. And it was traumatic – mostly for her, but also for me as I was determined to breastfeed, then felt completely shattered when I realised it caused her so much pain and discomfort. She was constantly hungry, but wouldn’t feed properly at the breast.

silent reflux 4

Silent Reflux is diagnosed by Paediatricians and Doctors from about 6 weeks, but in my experience it occurs much earlier than that. In fact, with my first two daughters it was at about the Day 10 mark when my milk was fully in and a feeding routine was really established that we realised problems were occurring at every single feed.

Babies with Silent Reflux usually will cry during and after their feed when everything seems to be going right. In our case, after consulting a lactation specialist who came to our home and spent the day with us to help with all the feeds, she saw no obvious problems at all. My milk was in, position was right, latch was right, yet my baby winced and squirmed and cried during and after every feed.

Burping her was also incredibly difficult. I’d learned all about the importance of burping a young baby during and after a feed, yet would spend up to 10 minutes at a time just trying to get a burp out of her to no avail. Occasionally when it worked you could actually see the relief on her little face. It was so frustrating. And heartbreaking – often I was in tears.

silent reflux

Symptoms of silent reflux can include:

  • Sudden bouts of crying
  • Being grizzly during or after feeds
  • Sour breath
  • Milk in mouth between feeds
  • Wet-sounding burps
  • Frequent hiccups
  • Failing to gain weight
  • Too much weight gain
  • Difficulty feeding

It’s really important to get Silent Reflux diagnosed properly, because not only is it incredibly painful for the baby and very distressing for the parents, but it can affect their feeding. Some babies with Silent Feflux can’t feed properly, and associate feeding with pain so fail to gain weight. Other babies comfort feed, or just suck, to relieve the pain, so put on too much weight. It can also lead to other health issues like damage to the oesophageal lining, stomach problems, respiratory infections, ear infections and vocal problems.

Helping To Relieve Silent Reflux

Unfortunately there’s not much you can do to make it go away, but you can help to relieve the symptoms in a few ways:

Bottle Feeding

If you are bottle feeding, ensure that you have a bottle that doesn’t allow your baby to swallow air with their milk. Try a bottle that is designed for reflux, sometimes called a ‘colic’ bottle.

When choosing a brand of infant formula, go for one is a bit thicker. I liked the Organic brand Bellamy’s made in Tasmania, Australia. And never, NEVER, ever shake the bottle to mix the milk. This only causes more air to get into the milk. Pour the correct amount of water into the bottle, add the formula into the water then swirl the bottle gently until it all mixes up.
silent reflux 7 Breastfeeding

Even breastfed babies can get Silent Reflux which makes breastfeeding tricky. Babies who are having pain or feeling uncomfortable won’t be able to suck for very long, and will feel uncomfortable at the breast. The burning sensation they feel from the reflux means they’ll feel pain when they suck for milk. Babies who are suffering from silent reflux will often fuss at the breast; squirming and pushing it away and sometimes crying in pain.

It can be very distressing for the mother who thinks there’s something wrong with her milk, or feeding technique, and the crying and fussing from the baby can be really upsetting. I spent far too many feeds in tears with my babies trying to get them to feed while they were fussing and squriming and crying in pain.

I didn’t know if they were crying in pain, crying out of hunger or some other reason. It was very confusing.

Sometimes shorter feeds can help. Try to feed for a few minutes and then sit them upright for a minute or so to let air escape.

silent reflux feeding marnie

You can also consult a lactation specialist for midwife to assist you with feeding. My lactation specialist helped me to feed my baby more upright, rather than laying down, so it was more comfortable for her.

Burping

If your baby is younger than 12 weeks try to feed them for a few minutes and them sit then up and burp or wind them.

Silent Reflux babies won’t always burp, but it’s important to hold them upright during and after feeds to allow air to escape. ‘Burping’ a newborn and young baby isn’t easy, and sometimes it can take up to 15 minutes in my experience. Rest them against your shoulder and gently put pressure on their upper back by making circles with the palm of your hand to let air escape. It may not be a ‘burp’ like you Grandpa does, it may just be the slightest sound. Hitting them on the back doesn’t help and may hurt them, rubbing their back in circles seems to do the trick and is more gentle. You can also sit them on your knee, support their neck and chin while leaning them forward slightly to wind them.

It doesn’t always take away the pain, but it can help to relieve it. But not always.

Sucking

Babies with reflux tend to love to suck more than babies without it, so my advice is to let them. Whether they suck their fingers, suck a dummy/pacifier or like to suck at the breast to ease the pain, just go with it. But be cautious that letting them suck at the breast may make it worse if they get more milk when they still have milk and air stuck in their oesophagus.

silent reflux 5

Advice

I had SO many people giving me advice, such as telling me to change my diet and cut out all dairy, don’t drink tea, don’t have any caffeine at all, don’t drink orange juice or any acidic food at all, don’t eat curry or hot foods, don’t eat spices or spicy foods… After a week I was basically eating bland pasta and cruskits!

YOU will know if something isn’t right so it’s important to seek help – from a professional – as soon as you notice something is wrong. All of my babies were diagnosed by a Paediatrician for Silent Reflux at about 4-6 weeks of age and were given medication to help it.

Reflux medications are used to prevent symptoms and help healing by reducing the amount of acid the oesophagus is exposed to. Some children respond well, like my daughters who thankfully responded within two days. But you need to find the right medication and the right dosage for your little one.

The good news?

They will grow out of it. Usually at about the time they learn to sit up, and when their digestion system matures, but not always. One of my daughters was 10 months before the symptoms subsided, another was about 7 months. Every baby is different. Occasionally the symptoms return when they are sick, but it’s not as painful or prevents them from eating like it did when they were a baby.

There is help and advice available and there are medications than can help, so seek advice from a health professional if you notice a problem. Don’t wait and don’t think it will go away on it’s own, your baby is too precious.

More information:

There is lots of helpful information at the Reflux Infants Support Association website http://www.reflux.org.au

5 Comments
  • Amanda
    October 28, 2017

    Thank you for this article. Just wondering if silent reflux is diagnosed on symptoms alone or does the doctor perform additional tests?

  • Kate
    October 31, 2017

    Hi there,
    This is such a great post! I have a baby with reflux and have started Zantac which is helping but I don’t think 100%. What medication were your girls on? X

    • SilviaK
      January 22, 2018

      Hello! Both my babies had it and were on Zantac then went on Losec, took 2 weeks to kick in and they were much happier! Good luck with it!

  • Michaela
    January 23, 2018

    Oh my goodness I felt your pain throughout the entire article. My baby is turning four months this week and I’ve been dealing with this for so long. He is EBF because he refuses bottles and pacis. I’ve been so worn down and felt like no one would listen to me, my gut knew something wasn’t right. Fighting me every feeding, walking around for hours trying to get a burp, not able to lay him down because he screams in pain, same with sitting in a car seat. Days where I just cry and rock him because my back feels like it’s going to break. Seeing him in pain made me feel like a terrible mom, what am I doing wrong?! Finally the pediatrician listened to me and we are trying to figure out his meds now. It is exhausting and heartbreaking but it’s nice to know I’m not alone and I’m not crazy.

  • Carla
    March 4, 2018

    This is a good article for 95% of babies and mothers facing silent reflux. Actually there is a more severe type called GORD which involves many other complications which you did mention but in many of those cases toddlers and young children are still struggling. Elimination of allergies from breastfeeding mothers and once bubs start solids does in fact help a lot and is the cause in a majority of the cases. My boy is nearly 3 and is still medicated. Also if losec or Zantac don’t work there are other medications in the same category that work for babies with faster metabolizing of medicine. Thanks for sharing.

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