What position should a baby with reflux sleep?

If your baby struggles with reflux or silent reflux, read these tips to help your reflux baby sleep. Sleep can be tricky for babies with reflux but tweaking some things can help!

As a first-time mom, there were so many things I did not feel prepared for. Meconium diapers. Latching woes. Hormones. And eventually, a baby with reflux who would not sleep.

About 8 weeks into motherhood, as I sat both emotionally and physically exhausted—spit-up in my hair and my daughter crying so loudly I was sure the neighbors could hear—I found myself holding her, bouncing up and down on an exercise ball and wondering.

How did we get here? And how do I get her to sleep without this darn exercise ball?

When your baby has reflux and refuses to sleep, you’re willing to try just about anything to fix it.

Spoiler alert: the exercise ball was not the answer.

Having a baby with reflux was never something that was on my radar going into parenting. I had no idea how common it was, and how much it could disrupt our daughter’s (and our) sleep. It proved to be one of the more challenging parts of her early life.

If your baby has reflux and sleep has become a problem, I hope that sharing some things we learned from our experience will help your reflux baby sleep better soon!

How Do You Know if Your Baby Has Reflux?

Maybe your baby hasn’t been diagnosed with reflux, but you suspect that it’s a problem. How can you tell if your baby has reflux?

The first thing to remember is that newborns spit up. It’s completely normal, and often begins when they are 2 to 3 weeks old. By the time your baby is between 7 to 12 months old, their digestive tract has usually matured enough to improve any reflux symptoms that they might have had.

In general, you shouldn’t worry too much about your baby spitting up after eating. However, if they show any of the following symptoms, it’s time to get the pediatrician involved:

• Arching their back in pain or crying during feedings
• Refusing to eat
• Forceful vomiting
• Constant crying
• Coughing or wheezing during and after feedings
• Spits up green or yellow fluid
• Tummy appears swollen
• Blood in the spit-up
• Constant hiccups
• Not gaining weight
• Refuses feeds

Get Your Newborn to Sleep!

Learn how to get your newborn to sleep with my Newborn Sleep Program. You’ll learn expert sleep tips for soothing your baby to sleep, getting in good routines, and slowly dropping night feeds. Learn more here.

It’s important to remember that not all babies suffering from reflux will show visible symptoms like spitting up. Your baby might have silent reflux, which means that they swallow their spit up and still suffer discomfort caused by the stomach acid.

Some signs of silent reflux include a chronic cough or wheezing, gagging/choking, sore throat or hoarse voice, runny nose, and sour breath.

There are therapies and medications your pediatrician can prescribe to help your baby’s reflux symptoms, but in many cases the thing that will help your baby’s reflux the most is time.

If your baby demonstrates some of the more intense reflux symptoms listed above, those months you spend waiting for their digestive tract to mature can feel like an eternity. In the meantime, you are probably wondering the same thing I did: how can I help my reflux baby sleep?

How Can I Help My Reflux Baby Sleep?

The first indication that our daughter had reflux was the screaming and crying fight she put up every time we tried to put her down to sleep.

At the time, I was trying to nurse her to sleep and dream feed—two methods that my mom friends had glowingly recommended. Unfortunately, it was not working out for us.

I later learned that reflux is often made worse by body positioning. When your reflux baby is laying down for sleep, the pressure of their full bellies on their lower esophagus causes their stomach contents to back up into their throat.

This is especially problematic for sleep, and explains why reflux symptoms can often be worse at night (when they are laying down with a full tummy).

The same goes for nap time when they’re put down after eating.

In hindsight, it makes sense that our baby with acid reflux wouldn’t sleep. I would stuff her tummy and watch her peacefully drift off to sleep, inclined in my arms. Then, as soon as I laid her down, she would wake up and yowl in discomfort.

It took a while, but we finally figured out some ways to tweak our pre-bedtime routine to minimize our daughter’s reflux symptoms and help her get to sleep easier. Here are some things you can try:

• Try smaller feedings, more frequently throughout the day.
• Stop nursing your baby to sleep. Instead, follow an eat play sleep routine and avoid feeding your baby 30 minutes before sleep.
• Make it a smaller feeding with lots of breaks for burping to keep baby’s tummy from getting overly full or gassy.
• Avoid super active play right before sleep. Be sure baby has been sitting up for a while without pressure on their belly.
• The best swaddle for a reflux baby is one that isn’t too tight around their midsection. We liked the Sleepea 5-Second Baby Swaddle.
• Consider eliminating dairy from mom’s diet if breastfeeding to rule out a milk allergy.
• Consider switching formulas if baby is formula-fed.
• Adjust your nipple size if baby is feeding from a bottle. A too-big or too-small nipple can cause your baby to swallow air.

How Should I Position My Reflux Baby for Sleep?

If laying your reflux baby down makes them too uncomfortable to sleep, does that mean you should change their sleeping position?

Sleep deprivation might make you desperate to try anything, but the safest sleep position for every baby—even a reflux baby—is on their back and in a flat position.

It is not recommended to place a reflux baby on their tummy to sleep. Doing so increases the danger of SIDS.

You might think that spitting up on their back would be dangerous, but a newborn’s gag reflex is designed to protect them from breathing in their vomit.

On the other hand, newborns are not strong enough to reposition themselves to breathe better when they’re on their stomach. Back is best, even for reflux babies.

Your reflux baby might have an easier time sleeping when they are in an inclined or seated position. Many parents use to love their Rock N Plays for this reason. And as you know, there are products on the market for most new parent challenges. It’s not surprising that there are incline sleep positioners marketed towards reflux baby sleeping problems.

Are Sleep Positioners Safe for My Baby?

It is important to note that the American Association of Pediatrics (AAP) does not recommend using incline tools or sleep positioners for sleeping babies. The ABCs of safe sleep recommend a flat surface for baby, which means using Rock N Play alternatives. However, your baby’s doctor might reach a different conclusion. This can depend on the severity of your baby’s reflux and other health factors.

If a medical professional determines that your baby’s case of reflux makes them a safe candidate for an incline sleep tool, be sure to ask your pediatrician (or pediatric Occupational/Physical Therapist) what brand and model you should buy.

The AAP reminds parents that just because a sleep positioner is available to buy in a store, it doesn’t necessarily mean the product has gone through extensive safety tests.

A sleep positioner should not be used to help your reflux baby sleep unless you’ve had a detailed conversation with your pediatrician about it first.

If your pediatrician gives the okay on using a sleep positioner, it’s best to put it under the crib mattress to help reduce the risk of SIDS.

Can you Sleep Train A Baby with Reflux?

It might seem like a reflux diagnosis for your baby means you’ll have to say goodbye to the plans you had for sleep training.

The truth is, having a reflux baby doesn’t mean you’ll never have a chance to sleep train. It just means that you’ll need to get their reflux symptoms under control before you try a sleep training method that requires your baby to fall asleep independently.

If your baby has suffered from reflux, try some of the more gentle sleep training methods that don’t require your baby to cry it out. There’s a chance that your baby will already have negative associations with crying in their crib from their reflux days. Crying can also aggravate the symptoms of reflux.

When you do start sleep training, be patient. Keep in mind that it might take your baby a little extra time to master sleep skills.

The good news is your baby will not have reflux forever. Most cases of reflux clear up by 18 months old at the latest. With changes to your routine and time, your reflux baby will have an easier time sleeping eventually!

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