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No one likes to see their baby grunt, snort or fight to breathe asleep or during feeding. In the event that no fever or cold exists, one might think of what is clogging it all up. The typical perpetrator? Newborn reflux congestion. Here’s how to clear newborn reflux congestion.
What is Reflux Congestion in Newborns?
This kind of congestion can easily be mixed with a stuffy nose or cold, but in fact, it is due to gastroesophageal reflux (GER), a very common benign disorder among infants. Although GER tends to get resolved by itself, the congestion that it brings with it can leave your baby uncomfortable and disturbed in their feeding and sleeping.
Newborn infants' reflux congestion occurs when milk or gastric contents return to the esophagus and the nose, due to which the nasal cavities become irritated and inflamed. Reflux congestion is different, mechanical, and positional, both caused by the feeding position of the baby and by the underdeveloped state of the digestive tract.
Since infants tend to breathe through their noses and lie down most of the time, even a little reflux can interfere with breathing and comfort.
The Reason for Newborn Reflux Congestion
- Immaturity of Lower Esophageal Sphincter (LES)
The muscle between the stomach and the esophagus, known as the LES, is poorly developed in infants. This eases the flow of milk back after feeding.
- Sleeping in the Nursing Period
Gravity will no longer assist in the retention of milk in the stomach when a baby lies flat after feeding. Part of that milk can pass into the esophagus and even the nasal cavity, leading to inflammation and mucus production
- Small Airways and Nose
The nasal passages of a newborn are very constricted. Just a small amount of refluxed milk can obstruct airflow and produce a congested sound, despite the nose not being really stuffed in the classic sense.
- Trapped Air or Overfeeding
Rapid feeding or air ingestion by the baby during breastfeeding may result in air and increased air pressure in the stomach, promoting reflux and nasal irritation.
The Symptoms of Newborn Reflux Congestion
The following are the symptoms of newborn reflux congestion:
- Snorting when asleep or noisy breathing
- Mucus in the throat/nose after feedings
- Difficulty in feeding as a result of nasal congestion
- Coughing or gagging on feeds or post-feeds
- Disturbed sleep and lying down flat
- Fussiness and crying following feeding
- Soppy gurgles or hiccups
How to Clear Newborn Reflux Congestion
As you have a newborn who is suffering due to the problem of reflux related to the congestion, your target will be both: to simply clear the blocked nose and to treat the actual problem that has caused that congestion. In worst cases, it can happen at home through safe, gentle solutions, depending on the severity. Moreover, in certain situations, your pediatrician can recommend medical treatment. We will discuss each of them below.
Medical treatment options
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In case the feeding, sleep, or development of your baby is being hindered by reflux congestion, your pediatrician can offer one or more of the following measures:
1. Reflux Medications
There are also those infants with moderate reflux who can be helped by medication to calm down stomach acid. These include:
- H2 blocking agent (e.g., famotidine)
- Proton pump inhibitors (e.g., omeprazole)
When complications such as low weight gain or pain symptoms occur as a result of reflux, then such medications can be prescribed in general. They do not completely relieve reflux but reduce acid levels, which diminishes irritation in the airways and the nose.
2. HypoOtherwise or Thickened Formula
Your pediatrician might prescribe a hypoallergenic formula to your baby, who is formula-fed and is suspected of having a cow milk protein allergic reaction. In other instances, the thickened formula can also be used as part of the spit-up-reducing strategy, since the milk is less likely to flow back into the esophagus and into the nasal passages.
3. Medication Regulated Feeding
You can be instructed to feed your baby less food more often throughout the day or to use special feeding postures. In the case of breastfed infants, your doctor may prescribe a change in diet to the breastfeeding mother in case of suspected food allergies.
Never attempt any medication switch, formula changes, or other significant changes to your baby's feeding routine without consulting your healthcare provider.
Home care measures
In the majority of cases, the newborn's reflux congestion subsides over time, and only basic home measures help reduce swelling the stomach and clear the airways. The best doctor-recommended methods are as follows:
1. Gentle Nasal Aspirator
A safe and gentle nasal aspirator is one of the best ways of clearing the blocked nose of a newborn, particularly when the blocked nose is a result of reflux. The Momcozy 2-in-1 Spray & Suction Electric Nasal Aspirator is a parent-friendly device designed with the sensitive nose of a baby in mind.
The reason it is so effective:
- The integrated saline spritz disperses viscous mucus and reflux leftovers.
- Mucus is efficiently removed with the suction level set to safe levels.
- It is silent, washable, and rechargeable, and it is good to use it daily.
Its use:
- Loosen mucus by spraying a small dose of saline.
- Empty the nostrils using the suction tip.
- Repeat at meal times preceding sleep time.
This will give your baby immediate benefits, enabling them to breathe and consume more easily.
2. After Feed Time, Keep the Baby Upright
The most basic and yet effective, ignoring the presence of reflux, is that as soon as you finish feeding your baby, hold them upright as long as possible, i.e., 20 - 30 minutes. Gravity helps keep the milk in the stomach, preventing regurgitation into the throat or nose.
You can:
- Carry your baby on your chest.
- Baby carrier or wrap
- Make your baby sit on an upright feeding chair (only during the awake hours)
3. Provide Smaller, More Frequent Meals
Excessive feeding may increase pressure in your baby's stomach and make reflux more regular. Try offering:
- Reduced volumes per feeding
- Halfway through and at the end of each feed, effervescing (burping)
- At 2-3 hour intervals, depending on the age and desire to eat.
- Slow-flow nipples are used for bottle-fed babies to minimize the amount of air they inhale and slow down the feeding speed.
4. Do not Lie Flat right after eating
Care should be taken to ensure that your baby is not placed flat on the back immediately after feeding, as this increases the risk of milk reflux. Rather, hold them upright when they are awake in either a supportive bouncer or stroller.
Note: Do not put any cushions on your baby's mattress or use wedges in the crib. These should not be slept in, and they can lead to suffocation, as quoted by the American Academy of Pediatrics.
5. Experience Tummy time, Wake Period Positioning
Supervised tummy time not only assists in the development of motor skills in your baby but also aids the drainage of mucous in the nasal passages. The maximum is a couple of minutes a day, and later, you can add more time to help your baby get stronger.
6. Monitor mom's diet (in breastfed babies)
When you breastfeed and your baby shows signs of reflux congestion, you may consider factors in your diet. Some sensitive babies are likely to develop symptoms after consuming dairy, caffeine, or spicy or acidic foods. There should be a conversation with your pediatrician before discounting food groups, though, and you should check your baby's reaction in case of changes.
Can Newborn Reflux Congestion Be Prevented?
Although in several cases, newborn reflux cannot be avoided entirely, as it is usually a common part of development, the risks associated with it can be avoided in several ways. Some of the ways to reduce the opportunities for milk to overflow into the nasal cavity are feeding your baby uprightly, spooning meals smaller and more often, and burping after feeding.
A good latch or slow-flow nipples can prevent air intake during breastfeeding or bottle feeding, thereby reducing the risk of reflux. Once the baby has been fed, maintaining them in an upright position for 20-30 minutes, then placing them back down so gravity can help keep the milk in the stomach, will be significant. It is also possible to clean the nose with a nasal aspirator and saline drops to keep the nasal passages open and reduce irritation.
Although these measures might not completely stop reflux, they can greatly alleviate the situation and prevent congestion from becoming an uncontrollable problem.
When to Call a Pediatrician?
Get medical assistance when your baby:
- Existing or progressively bad congestion
- Has a hard time breathing or turns blue
- Stops eating or vomits violently
- Has low weight growth
- Appears tired or exceptionally somnolent
- Green or yellow runny nose (can be a sign of infection)
Conclusion
Usually, reflux peaks at 4 months and clears up at 12 months--every baby is different, however. Never ignore your instincts; feel free to call your pediatrician if something doesn't seem right. Early parenting is already challenging in its own way, and newborn reflux congestion may complicate it, making it even more difficult, but usually, with a bit of tweaking, it becomes doable.
