Reviewed by Associate Professor (Adjunct) Jeanine Young, Nursing Director- Research, Royal Children's Hospital & Health Service District, Brisbane
Talk to your doctor whenever you have any questions or concerns about your child
For Infants (up to the age of 2 years)
- Keep your child upright for at least 30 minutes following feeds. Held up to your shoulder is a good position.
- Avoid slumping or an upright seated position (car seat positioning) as this can cause more reflux episodes.
- Avoid exposure to tobacco smoke
- Consider using a dummy if you are comfortable with the idea; they can be helpful for children with reflux
- When possible, change baby’s nappy before rather than after the feed. Avoid tight nappies and elastic waistbands
- Try feeding baby smaller amounts more often to reduce pressure on their tummy. If this upsets your child, try doing the opposite.
- Avoid overfeeding; talk to your child health nurse if you are unsure about this.
- Try burping baby frequently during feeds
- Avoid vigorous movements or bouncing baby
- If baby is easily startled by loud noises, leave a TV/radio or ‘white noise’ CD on for background noise
- Consider whether food allergies or intolerances may be a factor in your child’s reflux; & talk to your doctor
- Always follow the SIDS and Kids safe sleeping recommendations for positioning your baby for sleep. To reduce the risk of sudden infant death and sleep baby safely, you can (SIDS and Kids, 2007)
- Sleep your baby on their back from birth – never on their tummy or side (Side positioning is unstable and not recommended as an alternative to sleeping your baby on their back. Aids and devices intended to keep baby in certain sleep positions are not recommended (SIDS and Kids, 2007) (Qld Health, 2008).)
- Sleep your baby with their head and face uncovered
- Avoid exposing your baby to cigarette smoke, before and after birth
- Sleep your baby in their own cot or bassinette in the same room as you for the first 6 – 12 months
- Provide a safe sleeping environment night & day: safe cot, safe mattress, safe bedding, safe sleeping place
- For further information, go to www.sidsandkids.org
Please note that if your baby is under 12 months of age, elevating the head of the bed is not supported by evidence from research studies (Craig, Hanlon-Dearman, Sinclair, Taback, & Moffatt, 2004).
For Children (over the age of 2 years) and Teenagers
- Adapt strategies for younger children e.g. avoid lying down for several hours after meals, eat smaller meals more often etc
- Help or encourage your child to have good eating habits and make healthy decisions
- Help or encourage your child to avoid large meals, especially before bedtime or exercise
- Encourage your child to wear loose, comfortable clothing (and to lose weight if overweight)
- Minimise foods and drinks that cause irritation or increase the risk of reflux e.g. spicy foods, citrus fruits, tomatoes and other acidic food, peppermint, carbonated drinks and fatty foods. “Difficulty with any of these foods may be indicators that investigation for suspected food intolerance should be considered.” Joan Breakey, dietitian
- Encourage older children to also avoid tobacco smoke, alcohol and caffeine.
- Elevating the head of their bed may be helpful in reducing episodes of reflux
- Sleeping on their tummy or on their left side may help reduce episodes of reflux.
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Monday, 15 November 2010