Reflux and Its Implications on the Central Nervous System in Newborns
Silent reflux, a hidden but impactful condition affecting newborns, often goes unnoticed until it causes significant distress, yet it’s effects on a baby's comfort, development, and well-being can be profound. It may have implications for their developing nervous systems, digestive systems, and esophagus. Silent reflux, medically called laryngopharyngeal reflux (LPR), is a condition in which stomach contents rise back into the esophagus and reach the throat and larynx without the noticeable symptom of spitting up or regurgitation. When a baby is unable to be calm, comfortable, or sleep lying flat, they are living with heightened adrenaline, elevated cortisol levels, and pure exhaustion, to name a few.
Below, we will explore how silent reflux can lead to an exaggerated state of sympathetic nervous system activation (fight-or-flight mode) in a newborn, hindering the development of their nervous system, gut, and hormones. As a society, we emphasize not leaving babies to cry, ensuring they feel cared for and heard. We aim to help them co-regulate their nervous systems.
How does that work when addressing reflux is often delayed until caregivers are distressed or the baby shows severe signs such as losing weight, being unconsolable, and refusing to eat or sleep unless they are being held? In my professional experience, it doesn't, and we are doing a disservice to newborns when we do not eliminate the root cause of the reflux. Giving medications only masks the pain but does not stop any damage to the esophagus, gut, or nervous system. Meds are typically only given to severe cases by pediatricians.
Discomfort and Pain:
Reflux, whether silent or typical, can cause significant discomfort for individuals of all ages, including newborns. Silent reflux may lead to feelings of distress or acute pain in a newborn’s throat and esophagus, which aren’t always evident through common symptoms like spitting up.
Infants with silent reflux may show irritability or persistent crying, while others might appear calm, misleading parents into thinking they are fine. This lack of expression can hide substantial discomfort. Restlessness, such as fidgeting or unusual movements, may also indicate pain or unease. Recognizing these subtler signs is crucial for caregivers to understand the infant's discomfort and seek appropriate solutions.
Sleep Disturbances:
Infant reflux discomfort often worsens when they lie flat, making it hard for them to sleep soundly. This can lead to frequent night awakenings, preventing deep, restorative sleep and keeping the baby in a heightened state of alertness. Consequently, disrupted sleep affects well-being and increases stress responses, making it essential for caregivers to find ways to alleviate discomfort and improve sleep quality.
Due to societal pressures, families may misinterpret their baby's cues during night awakenings, opting to feed them instead of addressing potential pain. Feeding can reinforce reflux problems, increase food intake, and keep the baby in a sympathetic nervous system state for longer. While milk may provide temporary comfort, it can create a pattern where babies demand more food at night than during the day. Educating families on recognizing their baby's communication cues is vital for achieving a healthy, calm, and happy sleeping baby.
Frequent Crying or Fussiness:
A sustained period of irritability in an infant, often stemming from ongoing physical discomforts such as reflux, colic, or digestive issues (Colic and digestive issues can also lead to reflux. Research into colic increasingly connects it to the gut microbiome.) can lead to a vicious cycle of stress and distress. This relentless state of discomfort not only heightens the baby's levels of frustration and fussiness but also may provoke physiological changes, triggering the body's fight-or-flight response. 
This response is characterized by heightened sympathetic nervous system arousal, which can manifest as increased heart rate, elevated cortisol levels, and an overall sense of agitation.
As a result, the baby may find it challenging to reach a state of calmness and security. Over time, this ongoing stress response can interfere with their ability to relax, making it increasingly difficult for them to feel safe and comfortable in their environment, leading to more frequent episodes of crying and heightened sensitivity to external stimuli.
Breathing Issues:
When gastroesophageal reflux irritates an infant's airway, it can cause serious breathing difficulties, often resembling choking or distress. This irritation triggers a sympathetic response in the baby's nervous system, leading to anxiety and fear as the baby struggles to breathe. This is especially noticeable during sleep, particularly when the baby's head tilts back, which can open up the airways. Such behavior may indicate an underlying issue affecting their breathing, often seen in newborns with reflux and oral dysfunction.
Reflecting on my own experiences, I realized I had narrow nasal passages that I had widened for better airflow. As a child, I struggled with anxiety around suffocation, unsure if it stemmed from infancy or a forgotten traumatic event. Our understanding of newborn's behavior has improved, showing that babies communicate their discomfort and needs through movements and sounds.
It is remarkable how resilient babies are; they adapt to meet their basic needs even when challenged. This resilience underscores the importance of being attentive to infants' cues, which can provide crucial insights into their experiences.
Feeding Challenge:
When a newborn associates feeding with pain or discomfort, it can lead to a strong aversion to mealtime. This can cause increased stress and activate the body's fight-or-flight response. This anxiety may result in weight loss, raising concerns for caregivers and healthcare professionals and often necessitating medical intervention to meet the child's nutritional needs.
Recognizing early signs of distress is crucial for caregivers, as responding proactively can prevent feeding aversions. By tuning in to an infant’s hunger, discomfort, or emotional security cues, caregivers can foster a positive feeding experience, promoting healthier growth and development. Proper feeding contributes to a calmer, happier baby who sleeps better, supporting a return to the calming parasympathetic nervous system state essential for rest and digestion.
Generalized Stress:
Persistent discomfort, feeding difficulties, and disrupted sleep can keep a newborn in a constant state of stress, hindering their overall well-being. This chronic stress response affects the parasympathetic nervous system, which is essential for restful sleep and digestion. When compromised, the newborn struggles with comfort, leading to a cycle of feeding and sleep challenges that can impact their physical and emotional development.
An overactive sympathetic nervous system can exacerbate issues like reflux. Addressing silent reflux involves observing feeding practices, consulting functional health professionals when we first start seeing signs, and possibly making dietary adjustments or using specific positioning after meals. Identifying the root cause is key to finding effective, non-invasive solutions that help alleviate stress and promote the newborn's well-being.
In Conclusion:
It is important to proactively address a
baby's discomfort and stress in ways that support them physically and emotionally. A key aspect of building a secure attachment and promoting healthy emotional development is ensuring the baby trusts their caregivers to understand their needs. Caregivers should aim to understand and meet the baby's true needs rather than relying on their own interpretations of what the baby might require. When a baby learns to trust, their caregiver will respond appropriately, they feel heard, and their needs are met. This trust is crucial for developing a secure attachment to oneself.
At Gentle Giraffes Newborn Care, we are dedicated to educating our clients about their newborns' communication signals. We understand that the early days of parenthood can be overwhelming, and we aim to make this transition as smooth and positive as possible for both the newborn and the family.
The founder, Erin, is deeply committed to creating a nurturing environment where every newborn can form a secure attachment. This foundational bond is essential for supporting the child's emotional and psychological well-being as they navigate their journey through life. We provide tailored guidance and resources to empower parents, helping them interpret their baby's cues and respond effectively to their needs.
Our goal is to support not only the immediate care of the newborn but also to lay the groundwork for healthy emotional development in the years to come. At Gentle Giraffe Newborn Care, we believe that with the right tools and understanding, every family can thrive during this crucial stage. We strive to leave families with a well-rested baby and empower them to confidently navigate their parenting journey independently after we depart.
Founder, Gentle Giraffes Newborn Care
