When it comes to sleep, reflux can be a very uncomfortable condition to deal with and the burning associated with it would keep anyone up at night. If reflux is bad in some children, sleep training will need to be held off or postponed until the issue is handled. What can be done about it if you want to avoid medication for your little one?
Working with kids, reflux (and in extreme cases GERD) tends to come up a lot in the office (no pun intended). This is often an issue that begin when the child is just an infant and parents are told to medicate, and medicate some more. However, diet is an incredibly important factor and often we can greatly reduce and, in basically all cases, eliminate issues of reflux with simple, dietary changes. And that means no more meds (woo hoo!)
Here are my recommendations:
1) Look at your child's diet: in my line of work, the first thing that we do for our special needs kids with reflux is eliminate processed foods, sugar, gluten, and dairy. Reflux is often a sign of allergy or intolerance to food, and by eliminating what are common aggravates is a big step in the right direction. For example, it is estimated that 2.5% of kids 3 years and younger have some kind of milk/dairy allergy that often is developed in the the months after a child is born (foodallergy.org). However, when allergies are brought up, experts usually classify this as a severe reaction. Intolerance or sensitivity is usually not factored in. Gluten is also a food that often causes stomach issues, not just acid reflux. I know my husband had terrible heart burn issues for months, which completely disappeared after following a gluten-free diet.
If your child has acid reflux, consider eliminating the foods listed above just for 2 weeks to see if there is a difference. If symptoms subside or reduce, it's a pretty good chance that one of those foods was causing issues! When re-introducing new foods, always add one at a time to observe your child's reaction. If eliminating these foods do not help the symptoms, make sure to reduce or eliminate any of these acid causing foods/beverages: carbonated drinks, chocolate, sugar, oranges, sweets, salty snacks, fruit juices, tomatoes, and vegetables like onions, cabbage, broccoli, or cauliflower.
2) Breastfeed: according to kellymom.com, breast fed babies have a lesser chance of having reflux issues. This is certainly what I observe in my clinical work as well. Now, if you suspect that your child could have a food sensitivity/intolerance/allergy, consider reducing or eliminating any of the foods in point number one from your diet. Whatever you are eating, your child will get through the breastmilk.
If you exclusively bottle feed your baby (formula or breast milk), reflux can aggravate any feeding issues your baby might be facing. Here's a comprehensive guide on how to help bottle feeds go more successfully: https://momlovesbest.com/feeding/bottles/bottle-feed-breastfed-baby
3) Small meals, more frequently: for some little ones with reflux issues, cutting down the size of meals, but giving feeds more frequently often helps to alleviate the stomach and allows for proper digestion time. For some children, the stomach cannot handle such big meals and needs to work a bit more. Along with this, positioning is key when feeding as well. Make sure your child is in a perfect vertical position while feeding. This allows gravity to keep food and stomach contents down.
4) Don't eat too close to bedtime: my recommendation is that if your child is dealing with reflux (especially at night), avoid feeding at least 2 hours before bedtime so the stomach can get a head start and digest a bit before returning to a horizontal position. If lying down after eating, the stomach acids actually leak out into the esophagus causing a lot of discomfort (businessinsider.com). This might be a difficult thing to do for babies, but do the best you can.
Of course, if your child's symptoms persist, it is best to consult with your child's physician in order to solve the problem. However, simple dietary and lifestyle changes can make a positive difference in all aspects, including your child's sleep!