Q&A Forum

25/11/20

Suzanne

Hi, I am a child health nurse and met a family who have been elevating the head of the baby's cot mattress with towels. They did this because the baby slept better. The baby had a low birth weight 1.6 kg and the parents found when the baby lay flat of a night she would regurgitate more and be more wakeful. I can empathise with their situation but know this is an unsafe practice. Could you suggest an alternative way of sleeping that would address the regurgitation.

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Posted a response on 26/11/20

Red Nose Education

Regurgitation in babies is very common. All babies, including those with regurgitation &/or reflux should be placed to sleep on their back from birth on a firm mattress that is not elevated.

Babies protect their airway most effectively when on their back & flat. Swallowing is more effective in this position.
There is less risk of choking when baby is sleeping flat on their back.

https://rednose.org.au/article/will-baby-choke-if-he-she-vomits-while-sleeping-on-the-back

Red Nose has the following Information Statement here:
https://rednose.org.au/article/sleeping-position-for-babies-with-gastro-oesophageal-reflux-gor
https://rednose.org.au/article/my-baby-has-reflux
Regurgitation in infants is normal. It is normal for up to 50% of babies less than three months of age and 70% of completely healthy infants under twelve months of age to have regurgitation that is physiologic. Most of this regurgitation resolves spontaneously after 6 months, and completely by twelve months in 95% of babies.

GOR regurgitation or ‘spitting up’ is common in babies. Regurgitation occurs in about 50% of babies less than 3 months of age and resolves spontaneously, without intervention, by 12 months in all but 5% of babies. It is usually mild and self-resolving. GOR is a normal physiological process occurring several times per day in healthy babies both term and preterm and is normally cleared by swallowing. The great majority of children with the more serious GORD are over one year of age. Most GOR can be managed by educating and reassuring parents that it will resolve by itself without treatment or medication. Medical attention is recommended if vomiting is very frequent and growth should be monitored using parent-held records.

If a baby is in an elevated cot, further hazards may be introduced into the sleeping environment. When elevated, babies are more likely to slip down the cot and become completely covered by bedding, or if a pillow is used to elevate the baby pillows become a suffocation hazard

Some of the pictures in the articles linked above can be helpful when explaining this to parents.

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