Help for Reflux in Infants Without Pharmaceuticals

 

Ugggh…mmmmmnn….uggh….

 

…Pause….

 

Ugggh….mmmmnnnn…..WAHHHH!!!

 

Blurry eyed, you wake up to the sound of your little one fussing. After a feed and a change, holding them chest to chest, you begin to enter the golden zone of putting them to sleep. 

 

Yes…you’re almost there…

 

You can feel yourself sliding back into your warm bed, but….(it’s a big but.)

 

Every time you lay them down, they grimace and stir. Before they really wake up, you pick them up and begin the soothing routine all over again.

 

After they drift off, you make your way to the recliner INSTEAD of your cozy bed.

 

Thus goes the all too familiar pattern…

 

Responsible for keeping infants and their parents up at all hours, reflux is one of the most common complaints I see in clinic. Aside from pharmaceutical interventions, and being told that they will “grow out of it,” many parents are surprised that Osteopathy can help. 

 

Signs of Reflux

 

First off, we should cover what some of the signs you may notice if you suspect reflux in your little one:

 

• trouble keeping small amounts of milk down

• excessive spit up / vomiting

• fussiness in horizontal positions (including wake windows)

• inability to fall and stay asleep in horizontal positions 

• general fussiness for no apparent reason

 

This list is not exhaustive, but you get the point - they are uncomfortable and will let you know!

 

What is reflux anyways?

 

In short form, reflux refers to the presence of digestive stomach acid in the esophagus. Normally, the cardiac sphincter (separating the esophagus from the stomach) keeps this acid down in the stomach where we have a protective lining. Above the sphincter, the esophagus does not have a protective lining and the acid irritates the esophagus. 

 

To put it plainly, something is not where it is supposed to be…keeping everyone up at all hours.

 

Now, how does this happen? There are a number of factors, but I’d like to share two of the main themes that I find in clinic that lead to the presence of reflux.

 

1. Excessive Abdominal Pressure

 

During birth, we usually enter the world headfirst and ‘upside down.’ So, rather than our stomach being below our diaphragm in gravity, it (and the rest of us) are being pushed towards our cranium. The uterus does a great job and most of the time, everything settles back “into place” once we are Earthside. However, tissue and fascia (of any kind) can sometimes stay in a compressed state after birth. This leaves the stomach staying closer to the diaphragm than it would normally like. 

 

This is fine UNTIL extra abdominal pressure makes it difficult for the cardiac sphincter to do its job - namely, keep things down.

 

Part of the reason infants with reflux hate going on their back is simply because this changes the abdominal pressure resulting in more irritation to the esophagus. This is why parents resort to recliners for 30-40 minutes post feed…every feed.

 

*And yes, it is possible for the same mechanism to be found in Caesarian births as well.

 

2) Nervous Input

 

The tube transporting food from our mouth to our stomach is known as the esophagus. It has two levels of nervous input. The sympathetic input arises from the spinal cord from T1 (first thoracic vertebra ) to T10 and the parasympathetic input comes from our vagus nerve (which exits our cranium with the jugular vein). The vagus nerve helps our esophagus send the food down to the stomach to stay there though peristalsis (rhythmic waves). Just as your sciatic nerve doesn’t like to be pushed on, neither does any other nerve including the vagus and spinal nerves.

 

So, my job as an Osteopathic Manual Therapist is to assess for tissue tightness and any other impediments to the pathways of these nerves. If there are any ‘speed bumps,' then the signals sent to the stomach, esophagus or even the diaphragm can help contribute to reflux taking place. 

 

And yes, if you were wondering, nerves can be bothered by more things than disc herniations. Remember how it feels to hit your funny bone, aka, the ulnar nerve? 

 

Although there are other reasons for reflux to occur, these are a couple of the more common ones I see. There is more to say about the nature of the diaphragm and how it is different in infants and adults, but that is a topic for another time.

 

A Pharmaceutical Free Approach…

 

This is where your friendly neighbourhood Osteopathic Manual Therapist comes in. We are trained to assess and treat tissue blocks and tensions that can create the environment for reflux to rear its ugly head. Through freeing up the blocks affecting the stomach, esophagus, diaphragm and their respective neurovascular connections, the cardiac sphincter does its job. Keeping stomach acid where it should be and keeping you sleeping in your bed.

 

Contrary to what you may have been told, this is something you may not have to wait for them to “outgrow.” If structural blocks are in the way, you and yours can catch up on some zzz’s and cut your laundry loads down after a visit or two to your OMT!

 

For any questions, please feel free to contact me or book in for a consultation.

 

*Please note that not all Osteopathic Manual Therapists work with infants. You’ll want to do your homework and source one out who has the proper training and works with paediatric clients like myself. 

 

For a list of qualified OMT’s, check out the Alberta Association of Osteopathic Manual Therapists website (aaomt.org).