Latest / The Birth Lounge Podcast / Ep. 463: Baby Reflux Explained: Silent Reflux, Root Causes & What Actually Helps with Aine Homer [ Re-air Ep. 219: Baby Reflux]

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Ep. 463: Baby Reflux Explained: Silent Reflux, Root Causes & What Actually Helps with Aine Homer [ Re-air Ep. 219: Baby Reflux] · The Birth Lounge Podcast

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Hello, and welcome back to another episode of The Birth Lounge Podcast.
Let me ask you something.
Have you gotten your hands on my free download of my non-toxic baby registry list? It's all of the things that I put on my personal baby registry, and I spent hours, like 60-plus hours, exploring, researching, deep diving, rabbit holing into every single thing that went on this baby list.
I was really intentional about everything that I put on.
Number one, I didn't want to just get a bunch of stuff, because I personally believe that You know, I don't necessarily identify as a minimalist, but I also do believe that babies come with a lot of things, and people love to just gift you stuff when you have a baby.
However, I didn't really want my house to be filled with just a bunch of stuff, so I was very intentional about the things that I put on there.
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But I didn't want a lot of forever chemicals and microplastics.
And if you don't know anything about silicone, the US standard of silicone doesn't even meet the silicone requirements for pig troughs in Europe.
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Y'all, today, we are talking about baby reflux, which is something that pops in my email, my inbox, my text messages, my voicemails, my one-to-one consults, our prenatals with our one-to-one clients in The Birth Lounge, all over the place constantly.
People want to know how can they help their babies with reflux.
Another question that I get really often is, how do I know if my baby has reflux or if their spit up is normal? And what about colic or witching hour? All of these things seem to be connected, but there doesn't seem to be really great help out there.
It's kind of hit or miss whether your pediatrician has specific training in this and c- a- a- and can, you know, help step you through this.
It's hit or miss whether the IBCLC that you hire has knowledge in this as well.
And sometimes IBCLC support is so sparse in your area that you have to wait weeks or months to see someone.
So what are you to do in the meantime? I am so excited to sit down with Anya from The Baby Reflux Lady on Instagram to talk about this challenging and overwhelming time of navigating your baby's gastric development during the first few weeks and months of their life.
Anya is the mom of two girls who between them had the diagnoses of colic, reflux, silent reflux, CMPA, and multiple other intolerances and allergies.
She struggled with postnatal depression for years after having her babies, which left her feeling lost and alone.
During that time, her instinct was to always listen to her babies, so she struggled to accept the explanations that healthcare professionals offered.
She knew that her daughters were in pain and that there had to be a reason.
With a background in mechanical engineering, she then retrained in 2012 in traditional Chinese medicine.
Anya believed that there was one question which would unlock the answers for her children, and that is still the same question that she supports her clients with around the world, and that is, what is causing your baby's distress? Anya believes that no matter what is going on with your baby, it all comes back to this question.
Without further ado, Anya, welcome to the show.
Hey, HeHe thank you so much for having me here.
It's so, I'm so excited to talk about this topic today.
I'm very excited to have you.
I think this is a topic that a lot of people are going to feel like it has impacted them in some way.
And if you are someone who hasn't been impacted by baby reflux, really.
I'm glad for you.
We love that for you.
But for the people who haven't impacted, I think we all kind of have this cringe of like, oh, it's such a struggle.
And it can be really, really hard.
It's hard, you know, especially in the US to find accurate information.
And then it's always hit or miss whether your pediatrician is, you know, kind of knowledgeable about baby reflux and also what is their approach? Do they have a flexible approach or do they turn immediately to pharmacological kind of resolution.
So I think parents are eager for a conversation about reflux, and I'm really excited to dive into this with you.
So can we start a little bit just what is reflux and how do we tell reflux from normal, regular baby spit up? Because spit up is a normal baby thing.
Oh, I love that question.
HeHe because.
I'm going to question whether spit up is a normal thing or not.
So let's get back to basic questions.
Reflux is regurgitation.
That's all it is.
It is the movement of stuff from a baby's tummy or from anybody's tummy into the esophagus.
Sometimes it comes into the esophagus.
Sometimes it come up as far as the mouth.
Sometimes it goes beyond the mouth as like vomit.
Some babies even project all vomit.
It's all reflux.
Mm-hmm.
And for people listening, if they think their baby has silent reflux or they've been given a diagnosis of silent reflux.
The only difference between reflux and silent reflux is that silent reflux only comes into the throat.
So we don't see it.
It's not about hearing it, it's just that we don't see it.
Everything else about it is the same.
It is the movement of stomach contents in the esophagus or the food pipe for baby and.
Lots and lots and lots of children are given a diagnosis of colic early on or even pediatricians use the phrase purple crying to explain inexplicable crying.
It is my belief that every single baby is crying as a form of communication.
Yes.
And then it's about figuring out, well, what are they trying to say? Some of them are saying, I need a hug.
Some are saying, mom, where are you gone? Some are saying, I'm hungry.
Some are saying something hurts, and this is, it's just one piece of the puzzle.
Lots of babies have ongoing digestive discomfort, so they have no regurgitation whatsoever.
However, because everything else appears physiologically normal, so they're gaining weight, they're sleeping fairly.
Okay.
They're still feeding hit and miss, but it's okay.
So there's no.
External, obviously something wrong with them from a medical point of view, but they get diagnosed as having reflux because the medical community are taught that reflux is normal and it's, it's really important to know that our pediatricians and doctors are taught that something is normal, therefore, that is their belief.
Just because we want to take a different look at it doesn't mean that we are anyways wrong.
Yeah.
You know, it's okay to look for further answers and for explanations and what I encourage every parent to do is, and I think this aligns with your work as well, HeHe is to, you know, interview every single person you meet, be it a public health nurse or a pediatrician, or a midwife or a lactation consultant or me, or an osteopath or a chiropractor.
Interview everybody and go, Hmm, I think that bit fits for my baby, but that bit doesn't, and bring together your own village of help.
To be really specific for your child.
'cause every single human is Yeah.
You touched on looking into other options and it just like prompted me, like dropped into my head to say, if your gut instinct as, as your baby's parent is pushing you to look into other options, you should listen to your intuition.
Do you know how many people I tell on a daily basis, you know your baby better than anybody on earth and you may feel like you don't really know this tiny human.
And that may be true.
You may not know them deeply.
They may only be five days old, but you know them deeper than anybody else on earth for those five days that they are, for those 14 days, for that month, for those two months, for their six months.
Like you will never not be the expert in your child.
Look into those gut feelings, okay? And I love the way that you say put together.
We call it in the, Tranquility by HeHe community your own equation.
So take what fits for you, line 'em up in your toolbox and say, here's my perfect equation.
And then if one of your pieces of your equation breaks or isn't available or becomes not an option, have alternatives for those.
So I also love the, to guide parents to have almost a.
Hierarchy of options that they wanna look at.
This is my first choice, and if this one doesn't work, then I'd be most comfortable moving to this, and then I'd be most comfortable moving to this.
You know, and, you know, the different pivots.
Well, if this happens then we might have to skip that one because, you know, it's not appropriate anymore.
Yeah.
Gosh, I really love it.
Okay, so if well hang on.
Before we move into that, let's talk about normal spit up.
So let me share my belief about spit up.
So my master's is in human development and family studies.
So I look at anatomy a lot, and your baby is not born with that esophageal flap.
And so a lot of times we will see babies do what a lot of people refer to as happy spitting but it's just like normal, regular spitting your baby should not be experiencing weight loss with this discomfort.
It should literally just be like, oh, they spit up and that's that.
It is, you know, a nonchalant thing.
I believe that that is normal.
Anything, you know, kind of outside of that would strike me as abnormal, but not necessarily reflux.
So I have these three levels of, I think intensity or severity that I look at spit up.
How do you approach spit up in terms of that? Okay, so, and you're, so what I will say is, It's not always that it requires intervention or action, right.
It's really about understanding it first.
So every human on earth we have we have the lower esophageal valve, which, because it's a muscle, it's a ring of muscle.
Mm-hmm.
Muscle tissue in your entire child's body is not developed and not strong at birth.
Okay.
So this is where the, the weakness in the lower esophageal valve is often blamed for reflux.
Well, in my view, if, if this was true, then every single child born would have reflux because every single child has this inherent weakness.
Mm-hmm.
Now, the truth is the stomach is like an elasticated bag of muscles.
It's got three layers of And for the purpose of this, imagine it only opens up the top.
Okay.
It's like a balloon.
Because the, the palor valve at the bottom is clamp shot until the stomach and, and the center in the, in the stomach go, ah, this milk, this food is ready for the next stage of digestion and absorption.
So we've got this balloon right and we half fill it with milk and then the stomach does, its mechanical churning.
So the bottom of its squeezes and the top of it relaxes and stretches, and then the top of it squeezes and the bottom of it relaxes and stretches in order to physically mix the contents with stomach juices for digestion.
So if it's a balloon, I believe, and you can confirm, HeHe would you be happy if I said half full balloon? Do you wanna squeeze it? Well, anyway, but a half full balloon will expand in parts to keep the milk within it.
It's when we overfill the stomach or we overfill that balloon to its maximum capacity and then we try to squeeze it.
That's when we get this overflow.
Got it.
Okay.
So for my belief that every child who has spit up might have drank a little bit more than their stomach can cope with at that time, they might have excess air in there that is also stretching the stomach along with whatever milk they're drinking.
And so this is where we look at why is that spit up happening? And very often we will see babies who spit up now and again it might be after an intense period of crying when they were upset for some And so in when a baby cries, they go and in that gasp, they feel their stomach as well as their lungs.
'cause they're just drawing in as much air as they can.
Right? Huh? And so we're looking for these sources of possible air intake that then stretch the stone beyond its capacity, that when it goes to churn, it's giving that sort of regurgitation, that little explosive force behind the milk that then brings that up.
How does that feel? Yeah.
So would the overfeeding be kind of that green area of like normal slash doesn't mean intervention type of I guess cause or would you still recommend that any baby that has spit up up we try and feed them just slightly less, maybe a quarter of an ounce or a half an ounce? Or is that what your recommendation would be? So everything has to come down to parents' decision.
Mm.
Right.
So for some, for some parents, the happy spit up happens so frequently that it's stressful in terms of the laundry that it causes, you know, so it, we do have to take a one-to-one approach and, and parents need to say, how do I feel about this? Yeah.
Do you know what it's, it's once a day, we're okay, or No, this is 15 times a day.
I'm not okay with it.
If you do wanna take action and, you know, baby is generally happy and it's just that maybe they're drinking a little bit too much, then anything that your baby brings up, they're not getting any nutritional benefit from it because it's not inside their body.
So reduce the feed by that much.
You know, that's one really simple intervention.
Winding is a way to get rid of air before it becomes a problem.
And most people, we are, well, certainly in the UK and Ireland, we are led to believe that burping a baby's reserve for feeding time, baby can inhale air all day.
Anytime in the day we do it when we're talking, we do it, you know, babies do it when they're crying, they do it.
Depending on how good they are and what their latch is like with their pacifier, they can do it with that.
So we can also burp them at any time of the day so we can burp a baby before feed to reduce the size, the, the volume of stuff in their stomach.
Before they even drink milk.
Hmm.
So for babies who now my wheels are turning, so for babies who we feed them, we burp them and we do upright time.
And let's say it's a significant amount, you know, an hour, an hour and a half, and then we lay them down and an hour and a half to two hours later they spit up all of this milk reflux.
Normal.
We overfed them.
What in the world is that, that is, there is always something else going on.
And I can't say right now whether that's down to allergy, whether that's down to air intake, whether that's down to the endocrine system and stress levels and things like that.
What I can say is that we always take a step backwards.
Like my belief is for every child and it doesn't matter what age of client I'm working with, be them, you know, two or three days old or five years old.
The first place is information gathering.
So we look at gathering every single symptom behavior and thing that can happen in your baby's life.
They're all the pieces of the puzzle.
Mm-hmm, mm-hmm.
Okay.
And we turn the pieces over so we can see what they are.
And then we use a reference picture going.
Okay.
So when we've got all the pieces together, let's say we're doing a thousand piece jigsaw, the medical profession tend to grab a few pieces outta the box and see if they can get things to stick.
They don't bother turning them over to see them all the right way up.
And sometimes they'll be looking and they get some pieces to go together.
And most times it's not really gonna work.
I get parents to turn over all the pieces, color side up, picture side up, and we then have the reference picture as well.
So all we have to, to do is get three or four pieces.
And depending on the type of piece, you might only need to put two together and you're like, ah.
This is a pink bit with a bit of green.
And when I compare that to the picture, I know exactly where it goes.
I know what an orientation it goes in.
So we can tell a lot when we've got all the pick pieces together and we don't need to spend the whole time putting everything together in order to know what these are some of the next steps for each child.
if we don't turn over the pieces, we could be mixing up something so badly.
It could be as bad as doing an IM Posse puzzle.
You know, the ones with the thousands of minions on it, you're like, I dunno where to start.
But there always is a way through.
And so for me it's, the process is always the same, but the process gives different answers depending on what's going on for each child.
Yeah.
Gosh, I love that.
I talk a lot about puzzle pieces too.
It's just really important that you look at your baby as individual as their fingerprint because they are and this stands true too, for siblings.
So, you know, this may be your fourth baby.
They're gonna be different.
They're gonna have a ton of similarities to their siblings.
I, I, I recognize that.
But they are also gonna have a lot of differences.
So just because this is your second or third or fourth baby you know, don't, don't discount something just because your first baby didn't have it, or vice versa.
Just because your first baby did struggle really badly with reflux doesn't mean that your second and third and fourth babies will unless Aine, there's data behind that.
I say that purely anecdotally, that I've seen many of families have first babies that have terrible reflux that mean subsequent babies not data around that.
There's no, there's no data.
And the thing is, reflux has over 30 different causes that I've identified.
Okay, so in my mind I don't call reflux a disease.
The medical profession have this ger and gerd, the gastroesophageal reflux, which is apparently normal, and gerd, when they add the word disease on the end.
And the only difference according to medical literature is when is the disease form causes marked distress? Hmm.
Now, that's not a disease in the true sense of a word.
If you take a true disease like cancer, cancer has blood markers in every single case of cancer, no matter where in the body it occurs, there is a shift of the, the cells from being aerobic to anaerobic.
That's what causes tumors every single time, no matter where the cancer occurs.
So that's a disease.
It is the same pattern in every person, in every part of their body, wherever it occurs.
That's what cancer is like.
Covid, there was a test for it.
You either had it or you didn't.
They are diseases in the true sense of the word, reflux is a symptom.
Okay? Reflux is caused by something else always.
And if we take, like, there's a, a few pediatricians now in the UK that I've been in touch with over the last number of years have started.
They're like, actually, it is more of a symptom.
And when we start to look at it as a symptom to see what else is going on, then we get to identify that true underlying cause.
So, you know, for example, it could be things that happen in pregnancy.
Stress levels in pregnancy can cause reflux in baby moms or dads, like the, the microbiome and the environment kids are in can contribute to reflux.
The stress levels in the house can contribute to reflux, tongue tie, oral aversions, buccal ties, cheek ties.
Any oral dysfunction can contribute to reflux intervention during birth.
So ventouse forceps, even a, a straightforward oh, I can't even remember the word now.
Induction.
That's it.
Assistance from midwives if baby hasn't turned, and if baby's breached for a period of pre before birth.
If an e c V, you know, that external cephalic, what do they call it? Movement where, where Yeah.
Yeah.
To try and turn baby.
That can cause reflux.
Multiples, just simply babies being squashed in neutro.
Perhaps even having fight and beating each other up in neutro can contribute and cause reflux.
And what I want parents to know is that because we can identify what causes reflux, we can address it, we can resolve it, we can rebalance the body or rebalance the environment or rebalance the food or whatever it can be, I forgot to say, allergies and intolerances as well.
All of these things can contribute to reflux.
And so, I don't believe in the standard approach of, well, let's wait it out, or let's just try a different milk and let's try another milk and let's try another milk.
Or let's just switch bottles, or let's have a tongue tie revision because it's not guaranteed to work.
And lots of this is like nailing jelly to a wall very often doesn't work.
And I meet so many parents who have done all the things and they've still got really unhappy babies and no explanation, no understanding, and no learning from all the things they've tried apart from, well, it didn't work.
You know, it could be that they've done all the right things, but in the wrong order or for not long enough in order to still end up in the same place that they were.
So for me, getting a baby reflux free is actually a journey.
And it's just like setting the satin nav in your car.
Yeah.
You get into your car.
You set the Satnav, the first thing our satnavs do, which, you know, 15 years ago I used to have to drive half a mile in order for my SAT nav to find its G P S location and go, oh, I'm here.
This is where I'm at.
Capturing all of your baby's symptoms.
Is that data gathering? This is where we're at, this is our starting point, and it's the most important part of the journey because you then set the SAT nav.
Now I assume with everybody I work with reflux free their destination.
And so once we know the starting point, we can plan our route, you know? Where are you at the minute HeHe? In Boston.
Okay, so you're in Boston.
I'm in London.
If we say let's meet in New York, and I say, do you know what? If you just head west and I'll meet you in New York, you'll go all the way around the globe and you'll never get to New York, but I'll get to New York and I'll be sat there waiting for you going, but I gave her the same directions I gave her.
your directions are not the same as mine because the starting point is different.
You know, from, from my American geography, you need to go south or southwest a little bit to get to New York.
Yeah.
So it's a very different proposal for somebody coming from Sydney to New York.
You know, they can go west again.
They'll never get to New York just by going west.
So it's really important that we get the directions, we have our starting point, we have our destination, we plan the route, and then we actually follow the route.
Hmm.
You know, it's not good enough to know that in order to get to the shop down the road, there's two right turns, a left turn and a straight through the, the, the roundabout or straight over the crossroads.
'cause if you do them in a different order, you'll end up in a different place.
Hmm.
Especially if you're in England and we've got windy roads.
Unlike in other states, you've got lots of straight lines.
We don't have that over here.
So whether you take the first right or the second right.
So it's know how long you stay on that road.
How long do you need to do oral play and oral support after a tongue tie revision.
For example, some people do it for three days, some people do it for three months, you know, and there is a, there is the right thing to do, which could be different for every child.
And that's what makes, that's what makes solving the puzzle difficult is because people are grasping at straws and reading blogs going try these 573 things for reflux.
And so parents are overwhelmed.
I, I was there myself, I had no idea I was holding my child upright.
I was doing the most dangerous of sleep habits, which I won't describe because it's highly dangerous.
But as parents, we do what we need to do in the absence of explanations, answers and support, man, that's tough.
Just like let that sit in that if people had the support.
How many families could run so much smoother? You know, babies would be more comfortable, parents would be well rested.
We could have parents that are happy and joyous to wake up.
But sometimes with reflux it's so hard.
I know there's so many of you out there listening, being like, yeah, I wake up almost with a little bit of dread.
Right? And then you immediately feel guilty for like, oh my God, I should want to spend time with my baby.
But it's so hard sometimes with reflux, like it is really, really hard.
Okay, so you kind of confirmed with us that silent reflux is a thing you confirm with us that burping your baby does in fact help.
What about upright time? So sometimes, you know, we hear of parents saying, like I say, up for two hours after a feed with them during the night, and now you just made your feed a three hour thing.
You know, is, does upright time help? If so, how long is there a certain.
Way that we should be doing upright time in order to ensure it's success? What do we need to know about that? Yeah, so my view is looking for what the human body should be anatomically able to do.
That is my goal of normal.
Okay.
Just because things are common, I don't believe that they're normal.
I'm looking for how should we, the balanced, healthy human body operate.
And that for me is normal.
We are all designed to be able to lie down and to drink lying down.
And if we're not, if we're not able to keep food in our stomach when we're lying down, we have to ask why.
What else is going on? What's causing this? So my goal for all parents is that you can, you could even do, you know, if you're breastfeeding, you could do sideline and baby just rolls over and goes back to We shouldn't need this upright time.
I know for a lot of parents they will say it's the godsend, it stops baby.
Spilling.
But a baby spilling, they're, they're overfed, they've got more in their stomach than they really should have.
If you are doing a right time and it's helping, then great.
However, there's always something else going on under the surface.
Hmm.
So my goal is always to use the process to understand how do we unpick this so that we don't need to hold baby upright.
That they can be upright for, you know, a minute or two, a bit of burping to get any air and wind out.
And then they'll lie down and they're, they're asleep for a good 3, 4, 5 hours once they're, you know, learning to stitch those sleep cycles together.
Nice.
Okay.
Is there anything else that we should know about the tongue ties, lip tie, buckle ties? You had mentioned them briefly.
Mm-hmm.
But I know a lot of people bring those things to our team.
We have separate episodes about those ties and the problems that they can create with breastfeeding.
So if you're struggling out there with a tie of some sort, any sort of oral restriction, go back a few episodes because you will find the episode that we have about tongue ties and stuff.
But anything that we need to know about reflux that would be important, or maybe even questions that we should ask our pediatrician or in the us you guys, we, we actually should be seeking out probably some sort of frenectomy specialist or a pediatric dentist.
A lot of pediatricians don't know about this kind of stuff.
Yeah, you're absolutely right.
And what I will say is across the world, The level of understanding and knowledge about how the tongue impacts our overall health and how important it's is.
It seems to have been something the medical community in general have dropped.
Huh.
But as a, as an explanation, we're using our tongues now.
Mm-hmm.
I mean, if you try and tether yours to the bottom floor, the mouth, and try and speak, it's not gonna work.
Yeah.
Like it, it doesn't work.
We use our tongues to eat.
They're so important for manipulating and controlling food.
They're vitally important for a controlled and safe swallow.
If your child's been diagnosed with dysphagia or difficulty swallowing or an unsafe swallow, get the tongue tie looked at.
I have met children who have been too fed because of an unsafe swallow, and their speech and language therapist completely missed the oral tie that was blatantly obvious.
So, We must always seek out proper understanding on tongue tie.
And there's not a lot of people who are really good at it.
But if you're looking for a profession of people who really know it's myofunctional therapists, like that's my go-to all the time.
You want to make sure your tongue tie practitioner understands that tongue tie is important for all babies, not just those who are breastfed equally applies to babies who are bottle fed.
Yeah, it's important for speaking.
It's important for the developing our oral function, our teeth.
It's important for breathing.
My goodness, it's so important.
Now when it comes to reflux, it's really important.
We separate tongue tie from reflux for some babies.
You will get babies who have a tongue tie and a reflux, and the tongue tie is the direct cause of reflux.
So addressing it properly, I'll come back to that.
Addressing it properly can address and cure the underlying re the, the reflux.
We'll also get babies who have tongue ties and reflux.
And the tongue tie has nothing to do with their reflux.
'cause they might have, let's say a camo, protein allergy going on as well.
You'll get babies with a camo, protein allergy or some other food intolerance or allergy and a tongue tie.
And both are causing the reflux external symptoms.
So we need to know what to deal with and how to unpick the different symptoms and the nuances between things to say which is more important and, and you know, which ones are going to give the change to the family first.
What's most important to me after I've been learning about tongue ties for about 10 years now, and I keep, keep learning because there's so much more coming up, is to, first of all understand the tongue is 16 muscles.
Okay? It's eight pairs of muscles.
It is the most complex group of muscles over which we have conscious control.
Yeah, our heart is super complex.
We don't, we don't think about that.
We don't have to, you know, consciously make that work thankfully.
But with the tongue, we can get behaviors and functional things that look like tongue tie, but are actually tension within the muscle itself.
So oral play and exercises with baby in their mouth, absolutely vital before and after tongue tie revision.
And I have worked with children where we, it looks like a tongue tie, but we did a week of oral play first and the tongue tie disappeared because it wasn't a tongue tie, it was just muscular tension.
And I've, I've seen babies where they've just gone straight for the tongue tire vision, no change whatsoever.
Hmm.
And that's because it's muscular tension.
And so we're addressing the wrong thing.
So it's not like things are not as simple as they look on the surface.
We must always just triple check and go, yeah, we're happy with this.
Which is why now any of my clients, like I have an oral play course that anybody who comes into the reflux free baby class, you do because you know the way tummy time is a thing all babies have to do now.
And it used tot be, you know, when I was a, when I was a baby, there wasn't such thing as tummy time because there weren't so many containers.
Hmm.
I was just, I was my world was the floor.
The floor is just where we were.
Yeah.
I had a playpen, but I was free to move about that and explore that.
And in that I was getting my tummy time because I was physically moving my head as opposed to so many babies now are left in rocker so that they can see the world and they're supported.
They don't have to support their head themselves.
And so tummy time is now the conscious effort to say, make sure we're not removing development opportunities for babies.
You know, it's not saying all containers are bad, it's just saying, let's make sure we're, we're supporting babies at the right functional movement and, and developments and sport.
For me, oral play is a new tummy time because So do you go to the gym? He, yeah.
Yeah.
So you exercise from here down? Yeah.
I feel like my brain gets a lot of exercise every single day.
Like this conversation is kind of blowing my mind a little bit.
Yeah.
Yes.
And how much, I do, do, do you do facial exercises? Exercises? No, but I do like the gua stone and dry brushing.
I guess that's more for the, the skin rather than the muscles.
Yeah.
Yeah.
So exercises are chewing.
Chewing is our biggest exercise and.
Certainly in Western culture, we have become accustomed to eating soft food.
Hmm.
Lots of people would eat raw food and go crunchy and that's great.
And lots of people chew gum, like chewing sugar-free gum is incredible for building up our cheek muscles.
Okay.
It's incredible.
But we've, we've got so many muscles in our face and we don't exercise them.
Hmm.
And this is one reason that like, you know, we end up with the, with the saggy gel, is because we literally we're not toning and exercising the skin.
Huh? Like if we hold our tongue in the correct position, which is glued the roof of the mouth, we instantly get rid of the gel.
Yeah.
Okay.
So know I'm about to say the most like millennial thing ever, but I saw that on TikTok and I did see the viral videos of people like sucking their tongue up and it worked.
Yeah.
So this is where our natural resting position of our tongue should be on the roof of our mouth.
Yep.
And this is, again, this is something a, a trip, a tip for all parents to start doing.
First of all, remember it is our basic anatomical norm to breathe through our nose, okay? Because our nose has thousands of filters, it cleans the air like it's so important.
And when we breathe through our mouth, we don't filter the air whatsoever.
So what you can do is when your baby's asleep, gently pull their lip down and see where their tongue is.
Now, are you happy for me to show where it should be and what parents should see? It should look like this.
Okay? So anybody listening on the audios, come and watch the video for that bit.
You'll see where your baby's tongue should be now that when it's in the roof of the mouth, it creates this gentle pressure that pulls the arch down, which makes the nasal cavity bigger.
So it actually improves our oxygen intake.
We produce nitrix oxide, which is like our supercharger when we breathe through our nose, but not through our mouth.
It also develops a child dental arch so that their teeth, funnily enough, becomes straight and they create space in their mouth for their adult teeth.
So it's not just for infancy.
It's like a, a lifetime of things.
Breathing through our mouth is a skill.
Babies cannot learn before the age of four months.
Like, I don't know if your kids ever had a cold, but I remember my daughter first having a cold, and she was like to, and it's like, breathe through the mouth.
It's open and, and you're like, why can't you breathe through your mouth? They don't.
It's a skill.
They have to consciously learn to open the throat to the back and breathe through the mouth.
Hmm.
And it's vital.
It's absolutely vital for when we do have a cold.
It's our backup But after your child has a cold, make sure they close their mouth again.
Breathing through their nose, they get better quality sleep.
They get like the, the science.
And I will grab some of the links and connect the, the publications for this for you.
We are seeing children, older children with ADHD, like behaviors simply from poor sleep caused by mouth breathing.
Wow.
Okay.
Because when we breathe through our mouth, we get 18% less oxygen to our brain than we breathe through our nose.
Because this funnily enough goes up and like literally we're putting oxygen straight into the brain.
It goes across the blood brain barrier region thing.
So it like the amount of reasons why tongue position, proper tongue function, oral play is so important.
It just, it goes beyond Like it goes beyond just basic feeding, which is so often where the focus is.
And there's so many, I have heard even still so many parents come to me going, I was told to stop breastfeeding 'cause my baby had a tongue tie.
Like, no, let's address the tongue tie.
Yeah.
Wow.
Okay.
Gosh, this is just so, I think eye-opening.
I'm sure there's so many listeners out there who are like, what So many things make sense now.
Okay, let's shift a little bit to remedies.
Are there any like, I'm not gonna say surefire remedies, 'cause remember it's all like a fingerprint.
So we're, we're finding your baby's individual puzzle piece, but where should we start in terms of remedy and then what are the options that are maybe evidence-based that are pharmacological options, the medical options that we have? Okay, so the surefire solution for every child's reflux is to find and address the underlying cause, right? Every single time.
And for some babies, they may not be able to get all the way to reflux free.
For example, let's take a severe case where a child has a cleft lip palate.
Yeah.
So they actually have a hole and a gap in the roof of their mouth.
So their tongue cannot, they cannot reduce the air, they cannot prevent themselves from swallowing air.
However, for these children, we can create the, the set of strategies and feeding behaviors and feeding support that minimize the air, and therefore reduce the impact of reflux until they get round and have their, you know, the, the the surgery they need to have.
I do believe that for every child there is an answer.
I will mention because it is so important that if your child suddenly starts having reflux, you know, especially if they're already on solids and they've been established on solids for a while, and they suddenly start throwing up like proper regurgitating all the time or at the same time every day, please do not be fobbed off with, it's just reflux.
Okay? It might be just reflux.
However, it will still have an underlying cause that we can find, be it tongue tie or you know, where a child isn't maybe chewing their food correctly or they're taking on too much air while they're drinking or they're using, like I see kids using Cups with straws and every time they use a straw, well the first part of that is air.
Mm-hmm.
So we actually get children drinking lots of air when they start drinking fluids.
And that could be enough to start reflux.
So I don't wanna scare parents.
However, it is really important because I have seen too many cases where it has ended up being too late for some children because sudden onset vomiting is a sign of a brain tumor.
And so, and I have, I have too many stories of it being too late.
So get the answers.
Hmm.
Like when we can tell a story that logically adds up and go, well this is baby's behavior here, and then this is happening, and then that's happening.
And so this is happening.
It's like, okay, that all makes sense.
So when you address the underlying cause, there's a chain reaction and it all goes away.
If a child really had a brain tumor, taking any of those actions would not change it.
And so, For me, six to eight weeks is enough for any child to go through this process diligently, and we're able to piece the story together and tell the story and go, that all makes sense, or we're still scratching our heads and going, right now is the time to really ask the next level of questions.
So that has to be done first.
And this is where the medical community, when they step up, are brilliant.
However, it's been the medical community who have missed these children for two to three years and then it's too late.
So I also see a lot of children getting the pH probe, the barium swallow tests, the x-rays and all of that.
And none of these tell us for most children anything other than they've got reflux.
Hmm.
We can tell that a child's got reflux.
They are telling us with all of their patterns as well.
So I don't believe in those invasive tests.
Except in extreme cases where, for example, a child might have had like a, a tracheal atresia, so their trachea actually wasn't connected to their stomach and they've had surgery.
And then those tests tell whether their anatomical function is working correctly or they need, whether that surgery was a success.
Yeah, exactly.
But for a child who simply has reflux, you know, and I have so many parents come to me going, we've done all the tests.
There's nothing there.
We've checked out, there's nothing since they're going on.
It's like, great.
But your pediatrician completely missed it on time.
Like we, I, we always have to come back.
This is my, my engineering degree is we, I dunno if you're familiar with the phrase kiss.
Keep it simple.
Stupid.
Yeah.
Like literally we should be able to piece the story together and make a logical story.
And if we cannot make a logical story, then we need to go back and go.
Right.
What else could be going on? But we have to start with the simple things.
And it takes no more than about an hour to two hours to get enough of a sense going, oh yeah, that's the story.
I can see it here when it comes to the pharmacological interventions the only answer the medics really have is watch and wait.
Mm-hmm.
Because it's normal and baby will grow outta it or medication.
Mm-hmm.
And they have options of medication between famotidine, which is the H2RA, the histamine two receptor antagonist, which is a replacement for rantidine, which got called off the shelves.
And I will say, because you're a global podcast, rantidine is still on the shelves in South Africa.
It's still on the shelves in a few countries.
And the reason it was called off the Shelves in most countries is because of a carcinogenic contamination, which was never resolved.
That started in November, 2019 and was off the shelves in most major countries in the Western world by I think April, 2020.
It's still in places.
So for that reason, you know, it's up to parents to decide whether they want to use it or not.
Paridine is interesting because it's allowed from birth in the US and in the uk it's not allowed until the age of 12 years.
Wow.
Yeah.
With a clear statement on the I literally looked this up for an Instagram story last week, a statement on the medical literature that says, we've got no proven use of this in, in the pediatric population at all.
We're not, say it's not safe for using the pediatric population.
If you look up the electronic medicine compendium for the uk, so you know, we have massive degrees of variation in countries around the world.
And then the other one is the P P I, the proton pump inhibitor medications.
And these are ones that end in ole, so the active ingredient, you go omeprazole, omeprazole pantoprazole, lansoprazole, rabeprazole, any of those, they all work the same way.
And the only one which is, has got some history on the, and it's licensed for use under the age of three months, is liquid form the liquid suspension of esomeprazole.
Hmm.
That's the only one.
Everything else, if you look at the literature and what the pharmaceutical companies themselves say, don't use in babies under 12 months, so most of these medications, so FTE in the uk, in the US is licensed for use from birth, and all the PPIs other than one particular variant are all now being prescribed Essentially off books.
I can't remember what they Off label.
Off label.
That is what we say.
Yeah.
Yeah.
Wow.
I'm a little, sure.
And then we have gavascon.
Yeah.
Sorry, I skipped over Gavascon, which is very often the first step.
But forms a raft and so makes it more difficult for baby to vomit and often causes more digestive discomfort as a result.
Yeah, that makes sense.
Wow.
I'm a little shook.
I'm also a little not, this feels very, it happens a lot where other countries Yeah.
Have different standards and you know, things that they allow and don't allow in particularly medicine and cosmetics and food and all sorts of things.
Yeah.
And it's what I will say, it's really like there is, I don't believe medications should be the first port of call.
Yeah.
And I do believe they have a place.
Mm-hmm.
Yeah.
So it's, it's really about being.
Comfortable with what we're trying to achieve for the medication and why.
And I have like, I have an interactive medications guide that parents get when they join my reflux clinic membership.
Nice.
We go through all the medications, what each of them does, how they work, what are their side effects, what are the contraindications, how should they, how should they be used, and if you have them for your baby, you know, what should you expect in terms of review? What should you expect in terms of a weaning plan and all these sort of things.
What's really important is that if a baby is in pain and suffering with a acid burn in the esophagus, these medications, so that the P P I medications and the H two A, so that's the ZOS and the famotidine, they reduce the acidity of stomach acid so that it doesn't physically burn and damage the esophagus.
Okay? So that is when they are beneficial.
However, we shouldn't use them.
Long term without a plan.
Exactly.
Yeah.
They're not, they even in the adult population, all the literature is no more than six to eight weeks.
No more than three times a year.
Yes.
And I meet kids, been on these for two years with no review.
Oh, yeah.
Yet, so we're not, you know, the medical population are not telling parents the nutritional impact of these.
They're not telling parents about the long-term potential issues with, you know, community acquired pneumonia and all the other tedium, difficile infections, and so many other things that could be related.
So parents aren't getting the ability to weigh up their decisions on balance.
And I think that's really important for me.
Like I am very much about every single parent should have the.
Information to make informed decisions.
Mm-hmm.
Because that's all we like as humans.
All we can ever do is make decisions based on the information we have available at the time.
Yeah.
Yeah.
And you know, for anybody who made a decision prior to hearing this, and you got new information today and you're like, Hmm, don't ever feel guilty.
Because I know that as a parent, every single one of us has always done what we thought was the best thing in that moment with the information we had at the time.
And with the resources, you know, and resources is our level of tiredness, our ability to think whether we've eaten or not.
All these things make, like are really important.
And so if you get new information, allow yourself to change your mind.
Mm.
Allow yourself to go, okay, that serves us until now.
Or, I did that decision and this is where we're at.
Where do we go from here? You know? Yeah.
And so it becomes a journey rather than looking back and going, oh, I wish I did that and I wish, don't ever wish that you did something different.
But give yourself the choice to go, actually, I wanna read up a little bit more about this and make more of an informed decision.
Yeah.
And if you're happy with where you're at, that brilliant, like that's where we should always be.
We will always feel more comfortable with ourselves when we go, I'm happy, like I trust that doctor.
I'm gonna do what they say and that's fine.
And there's other people who go, nah, I just didn't like the way that person spoke to me, so I'm gonna dig a little bit more.
Whatever your reason is, it's good enough.
I agree with that.
I think you should really listen to your intuition and that's not just about your baby symptoms, but the feeling that you get from your providers and the options that they present to you and those sources that they give you or you know, digging into your own research.
Okay.
So I do have a question about the pH of the belly you were talking about, it changes it from, you know, acidic to a little bit more neutral or basic, so that must throw off the pH.
And then previously you had also talked about the gut health.
So I'm wondering if there is a reason, or maybe there's data behind kids with reflux being on a probiotic to help rebuild that gut health or help improve that pH of the belly.
Is that change in pH even a problem? The change in pH is a massive problem because when this is what causes a lot of the issues.
So we primarily see our stomach as part of the digestive system.
It's actually also a really important part of our immune system.
Hmm.
The acid in our stomach, is there to kill some of the bacteria we eat with food.
So if it's not acidic, we're now eating bacteria and they go into our small intestine.
And this is where there, and there is, there's lots of research around the use, long-term use of P P I medication and H2RA medication and heightened increase or increased risk of small intestine bacterial overgrowth or sibo which is SIBO takes far longer to resolve than it does to create.
However, it does take time to create.
So if your child is on a medica, one of these medications and has been on them for a while.
I will say I've not yet met a child under the age of 18 months who has had SIBO because Okay.
And the, the kids who are, who've been 18 months who did have sibo, they were literally on the medication from five to six weeks of age.
Yeah.
The way through 18 months, pretty much.
Yeah.
So and so probiotics won't actually prevent SIBO because you're, yeah.
I mean, probiotics can be amazing.
And we also have to be careful, especially if we're using a P P I medications because p P I medications are, and the H2RAs, so the gastric acid suppression medication, they also elevate the histamine levels in children.
Because histamine is the neurotransmitter that tells our body to produce stomach acid.
And if the stomach acid is being blocked in any way, the stomach goes, more histamine, make more stomach acid.
It's trying to communicate that all the time.
So we elevate the levels of histamine, histamine circulating in our blood.
Now histamine is completely normal.
It helps our body do so many things.
However, we do have a threshold level of it.
Okay? We have the, we have a D A o.
Diamine oxidase is the enzyme that breaks down histamine.
So do you know the big glass jars with a tap on the bottom? Yeah.
Yeah.
So if you leave the tap open, right? The tap open at the bottom is like I is the, is our diamine oxidase, right? That's our ability to break down histamine.
And so we can leave the tap open and pour water into the jug and it won't ever fill up because it's flowing at the bottom until we do something that artificially.
Increases the flow of histamine into the body.
So now we've got, imagine we've got four jugs pouring water into this jar.
We still have this maximum rate.
The tap doesn't open any further.
We only produce a certain amount of the D A O enzyme, and so we can actually fill that jug and as soon as it overflows, we now get these allergic symptoms.
That's what histamine sensitivity is, is when the histamine in our bodies breaks its threshold level, and so it can flare for, for babies who are on these gastric acid suppression medication, their histamine levels get elevated really quite quickly.
And so if they have, you know, there's so many other things that can contribute to histamine levels like inflammation and tiredness and so many things, but we can get children who appear to be allergic to everything.
Hmm.
We can't figure it out, and they might have Sunday dinner and they were fine, and then by the time Monday comes and they eat the very same meal, it's actually leftovers, but they react to the leftovers.
These are clues that it's a histamine thing going on, and the reason I come to this at this point, the conversation is because probiotics, the bacteria in our gut produce histamine.
So sometimes we get babies and they start on a probiotic and it's all with the gut intention support in their gut health.
If they're near a threshold level on their histamine issues because of ongoing P P I medication or ongoing H two R a medication, then it could be a trigger and it looks like they're allergic to something when actually they're not.
It's a histamine equation.
So again, this is where understanding and having all the pieces of the puzzle first.
It gives us such a deeper insight as to what's going on.
And so I really believe in solving reflux first.
And for babies who are on medication solving the reflux, then they, if they're not regurgitating, they don't need the esophagus being protected anymore.
Hmm.
So we want medication and then we get to see what their body really does.
So if someone felt like their baby was having those symptoms, what kind of specialist would they seek out? Are they going to an allergist? Are they going to an endocrinologist? Who should they take their child to? They can pretty much stay away from the me we Western system, to be honest.
Find a functional doctor.
Yeah.
Functional medicine.
You know, for children and toddlers, I've got a basic set in my weaning course, which combines a whole lot of stuff about the developing digestive system.
And we need to look at, like, we need to find people who really understand it all.
Hmm.
And I've yet to find somebody who's put it all together, including with the medications.
So I have a basic course for toddlers on this.
And then we can get so far because what, what's really important to, we address the reflux.
Like if you functional doctor isn't looking at reflux as an underlying cause and doesn't understand tongue tie and things like that.
We need to do those first.
Get baby off medication.
And then placebo, definitely it's functional medicine, functional practitioner who really understands the different varieties of bacteria and can find really specific bacteria.
And I say you have a lot more of support in this in the states than we do in the uk.
I've got a good friend who's become a good friend from being one of these.
I can't believe that happened.
Clients.
Hmm.
You know, the two of us.
Learned so much from her daughter.
And her daughter is probably six now, and I think she can eat 20 foods.
Wow.
Like, and 20 foods is not a lot.
You want your kid to be eating 20 foods by the time they're six months.
Yeah.
This child literally had a cascade of errors from the medical profession from the beginning.
So many mistakes and so much learning for her mom.
And I, like her mom trained with me and now does this as well.
And when she was going through supporting resolving her, her child's sibo, she was importing the probiotics on the right support from the US because we just don't have that level of knowledge in the uk.
You know, functional medicine in the US is superior, I think, than anywhere else in the world.
So while we have this really strong medical western system, you, you guys have a really, really good functional medicine system as well.
Yeah, that's amazing to hear.
I love functional medicine.
Our team is, we're really big supporters of functional medicine and a number of us see functional medicine doctors kind of as.
primary care physicians.
Okay.
I think that we've covered so, so much, but I do have one final question for the people who are like, okay, great.
All of this, or a lot of this, most of this applies to me.
I have a plan of going forward but in the meantime, I'm stuck with these really, really hard times where my baby is just inconsolable and I know it's gonna take time to get these appointments done.
Do you have tips for parents and how do they cope with these really hard reflux times? This is the time that if your doctor has diagnosed your baby with colic, then this is what you're gonna call like your colicy time.
Why, right? Or that it's different than the witching hour, but those really hard kind of reflux times.
Yeah.
So there, there's a few things.
First of all, please follow me on whatever social media platform you're on.
There's tips there.
I post daily, Monday to Friday.
Grab me on the stories.
There's a q and a box most Mondays, so come and follow, get information if you can get the book.
The Baby Reflux Daily Survival Guide, have time to read is fantastic.
I've got online courses and I do one-to-one support as well, so we've always got ways to help.
However, in the meantime, the first thing I would say is to breathe.
Okay.
It is the most stressful time.
incredibly worrying, and I know this because my own journey involved three years of a relationship with postnatal depression.
You know, it was tough.
It was low and actually conversing.
HeHe, you said, you know, sometimes the mornings we were dreading things.
I dreaded the night because I felt so lonely at night.
I was like, My husband's gone to sleep and he needed to sleep 'cause he needed to go to work and I was scared that he was driving the next day.
Oh my goodness.
But simply breathing, okay.
Our breath can be the first point of grounding and it doesn't change what's happening in the world, but it does change how we can cope with it.
The first most important thing is to focus on your exhale being longer than your inhale.
Hmm.
That moves us from our stress state into our calm And so we gain the ability to think and to cope and to tell ourselves we are absolutely amazing parents and our babies chose us for a reason.
You know, so remember that always.
You said it already, and I completely agree.
Every parent is the world's leading expert in their baby.
100%.
If you feel that your baby is more unsettled than they should be, you are right? Yeah.
What you live in your life is reality.
You know? Don't have anybody gaslight you and say, well, that can't really be happening.
You can go, well, you might think that.
And remember, you are in your life.
Nobody else is.
Ask for help is another one so hard.
It's, it's really hard.
And it's, it's also really, I mean, I found it really hard because my mom would tell me, oh, well I did this for you and this is how I parented and you turned out all right.
And it's not that I was trying to, in any way shame my mother about how she parented me.
It's just that right now we have encyclopedias in our hands.
We have access to so much more information than our parents ever had.
Mm-hmm.
So remember that our, your parents, if they're offering, oh, I read this blog and I read that blog.
It like, it used to frustrate me so much going, don't you think I've tried all of these things? And if people want to help, kind of go, actually ask your mom, your mother-in-law, your father, whoever is available to help.
Do you know what? Can you hold them? You seem to be able to burp them.
Let that be somebody else's superpower.
Yeah.
You know, so allow that help to come in and ask them to tailor it.
Kind of go, do you know what I heard about this chick on a podcast? Would you ever listen to the podcast? Look her up on Google, see what you find out.
You know, get other people involved in the research as well.
We don't have to do the journey alone unless you allow yourself to be alone and.
I found it.
I didn't know who to ask for help and I didn't know, well, I didn't, I didn't exist, you know? So if you have found this podcast, just follow my Instagram, go there first, port a call, and you will realize you're not on your own.
Yeah.
You know? And if you ask your friends, 50% of babies in the UK and the US have reflux.
Wow.
So you're most definitely not alone, but we often suffer in silence, telling ourselves that, oh, their child is fine at the minute.
So they don't have these problems.
We never know what's going on behind somebody else's closed doors.
So be open with your, with your friends conversations going, do you know what? I'm having a really tough time and I don't know if this is normal or not.
Yeah, yeah.
Gosh, you're never alone.
Postpartum is such a journey.
It's got its highs and its lows and it has wonderful moments, but it also has a really hard moments.
And just remind yourself that those are.
Fleeting, right? They are temporary and there is another side to this.
It just takes sometimes a lot of work and that's okay.
You can, you can totally do that.
So Aine, you've given us a lot of places that we can find you and follow you.
Is there any other place that people can connect with you if they'd like to work with you? So Instagram is great and then my website, which is www.TheBabyRefluxLady.Co.Uk
sort of, they're the two main places.
There's also Facebook and TikTok and all the other regular places, but they all point to the website.
And yeah, I think we've got a special code for your listeners, hehe.
We do.
And I will link that in the show notes for everybody to take advantage for that.
Brilliant.
Brilliant.
Because what I will say is that there is an answer.
There's always an answer.
Sometimes, you know, this is not about parents not knowing the answer, because if I ask somebody to translate a book into Hebrew, unless you actually spoke Hebrew, you'd probably feel quite comfortable going, I don't know how to do that.
that's okay, because we can all learn.
Understanding reflux is the very same thing.
You can't be expected to know this stuff unless you've learned it.
And, you know, think of me as your reflux dictionary.
I help you decipher what's going on and, and read everything for your baby so you can do it yourself to find this perfect puzzle pieces.
Yeah, this is such a fantastic conversation.
Listeners, if you wanna get in touch with Aine, you know how to do that and we'll link all of her links in the bottom.
Thank you so much for tuning in today.
I love hanging out with you, and it is an honor to be your go-to gal when it comes to preparing for your baby.
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I'm HeHe, and this is the Birth Lounge Podcast.