Myth Busted! Inclined Sleep Does Not Help Reflux, Makes It Worse
Parents of babies with reflux have long been advised to lay their babies down at an incline, but new evidence suggests that inclined sleep does not help reflux babies. In fact, it makes things worse.
Babies who suffer from Gastroesophageal Reflux Disorder spit up frequently. This leads to increased fussiness and difficulty sleeping. Parents also worry that a baby who spits up often in his sleep may choke. Pediatricians often suggest that parents of reflux babies put their babies to bed at an incline to help alleviate these concerns. However, this advice has been debunked and dismissed as dangerous.
Reflux Isn’t Dangerous But Inclined Sleep Is
First of all, parents do not need to worry about babies choking on their spit up while laying flat. Studies have shown that this does not happen. Rather, babies have a built-in reflex that lets them cough up their spit up or simply swallow it back down.
Secondly, inclined sleep is always unsafe and puts every baby at risk. Inclined sleep includes using books to elevate the crib at one end, letting an infant sleep in a seat, or any other way of propping the baby at an angle. The danger here is called positional asphyxiation, which is when a baby suffocates because of the positions she is in. A baby in a curved position will have her windpipe bent, and it can bend so far that it is blocked and she cannot breathe. Think of the windpipe as a straw that is bent. If it is bent too far, it will close completely. Tiny babies do not have the facility to correct this because of their limited head control. This can lead to sudden death that cannot be prevented by supervision.
So, putting a baby to sleep at an incline adds a risk where previously there was none. But does it stop the spit up? According to studies referenced by the American Academy of Pediatrics, elevated sleep did not have an impact on reflux symptoms. There was some suggestion that it could worsen it. Then again, gastroenterology experts claim that it does help; nevertheless, they recommend against the practice for safety reasons. Not a single reliable source stood behind the recommendation to incline sleep for any baby unless there was a danger in not doing so. Reflux does present difficult symptoms, but it does not compromise the baby’s safety in and of itself.
What To Do Instead
The truth is, inclined sleep is extremely dangerous for babies. All babies need to sleep on a firm, flat surface. The symptoms of reflux, although challenging, will be grown out of and they are a small discomfort compared to the alternative. And again, reflux itself poses no danger to a baby in an otherwise safe sleep environment.
Fortunately, there are safer ways that parents can help their babies avoid the unpleasant symptoms of reflux. Propping the baby up (such as in an infant bouncer) for 30 minutes after each feeding while the baby is awake can help. Feeding the baby after naps instead of before will help make this work. At bedtime, parents might feed first and then carry out the rest of the bedtime routine, like reading stories, with baby awake and upright in a bouncer. It gets more complicated when infants need milk in the middle of the night. Some parents stay awake with their little ones for 30 minutes after the feed, while others try to reduce night feeds or use a pacifier in their place.
In more serious or painful cases, a doctor may prescribe medications or thickened formula. In other cases, parents mistakenly believe their baby has reflux. If you have an inconsolable baby, check for milk protein allergy, ear infection, and urinary tract infection before assuming it’s reflux.
Sometimes pediatricians will still suggest inclined sleep to parents with reflux babies. The serious risk of positional asphyxiation is more recently coming into the spotlight and not all doctors have updated their recommendations. It’s very important for parents to stay up to date. When it comes to reflux, inclined sleep is not the right answer.