Dana: Hi, I’m Dana. Welcome to this week’s video chat. Today our question comes from Lydia.

She is wondering, “How do I sleep train my baby when he has reflux?” That’s an awesome question.

I’ve been in this business now for 11 years and every year I see more and more babies suffering from reflux. I’ve got two thoughts around that.

One is that I do think it’s becoming a bit of a catch phrase for any sort of fussiness that we see in babies. I’ve had clients tell me that they went in and expressed a bit of concern around their child’s fussiness and were given the diagnosis of reflux without any testing going on behind it.

I think that’s a little concerning in some ways that we’re putting babies on a lot of medication that, perhaps, don’t need to be on it. Also, fussiness is often caused by tiredness.

The two really do go hand in hand. I think the first questions should always be, “Is your child getting adequate sleep? Are they napping at appropriate times? Are they napping long enough? Are they sleeping an appropriate amount of time through the night?”

If the answers to those questions are, “No,” then that would be my first step. Let’s get the schedule in place. Let’s get this child sleeping well, and then we’ll see if those symptoms of fussiness subside.

Now I’m not saying that there aren’t legitimate cases of reflux. I am not saying that at all. It can be a very serious problem for some babies, and it really does often need medical intervention.

Please, it’s always worth investigating if you have any suspicion around that. Now as far as sleep training a baby with reflux goes, there are a few things I want you to consider.

Number one is to make sure you feel like the reflux is under control. Now that might mean that the baby has outgrown it to the point where you don’t notice the symptoms as much. They seem to be settling in and doing much better.

Or, that they’ve been on medication for long enough that you can really evaluate whether or not you see some relief being provided in the medication. It’s very difficult to start sleep training a baby when they’re right in the heat of reflux because it’s painful.

It’s painful to lie down on your back in bed and they will often cry because of it. The crying will aggravate the symptoms, and the whole thing will not work.

If you do feel like, “Yes, it’s been a month or two. We see really great signs of improvement. He seems to be doing really well with it and managing it,” then absolutely start sleeping training.

A couple of words of advice around that, though, is I do find that most babies who have had reflux or have reflux have a harder time learning sleep skills. Not to say that it’s impossible or that you shouldn’t do it, just know that it’s going to be more challenging.

I think it might be that they have some lingering memory that it’s painful to lie in the crib or that time to sleep has some negative associations around it. That could be why I find that the crying is a little more intense with babies who have reflux.

As long as you know that going in, then it won’t surprise you when it occurs. I find that it takes an extra week or two for these babies, whereas a baby without really starts to master their skills within a few nights and by the end of week one is doing really, really well.

Babies who have reflux, it’s into week two before you start to see signs of improvement and success. Keep that in mind.

You might also want to have a little bit of an incline on your crib mattress. There are lots of cool things you can buy now that could help levitate the head a little bit more so that it’s not such a flat surface on the neck, so that the acid doesn’t build.

You can try that, absolutely. If you’ve been putting your baby in some other place, Rock ‘n Plays are common for babies who have reflux. I would suggest that you start sleep training in the crib.

The crib is where you want to end up long term. It is always better to start out where you plan to end up. Make the move all at once.

Thanks so much for that question. Sleep well.