Cycle of infant reflux signals a call to help mothers

February 14, 2018, University of Western Sydney
Cycle of infant reflux signals a call to help mothers
Credit: University of Western Sydney

Western Sydney University research has found that first-time mothers with mental health issues – in particular, maternal anxiety – are five times as likely to have their baby noted as having reflux when admitted to hospital.

Far from concluding that mothers are responsible for their child's gastro-oesophageal reflux (GOR) or gastro-oesophageal reflux disease (GORD) – the Australian Research Council (ARC) funded study provides powerful evidence that mothers require more support.

Professor Hannah Dahlen from the University's School of Nursing and Midwifery led a research team which analysed the reasons for infants being admitted to Karitane and Tresillian, the Residential Parenting Services (RPS) in NSW, within the first 12 months following birth.

The three-phase project included an analysis of NSW hospital records from 2000-2011; a random audit of 326 medical records from admissions to RPS; and eight focus groups with 45 nurses and doctors working in RPS.

The results, published in BMC Paediatrics, reveal:

  • Of the 1,156,020 admissions of infants to NSW hospitals, 11,513 – or 1 percent – contained a diagnostic code for GOR/GORD.
  • 36 percent of babies admitted with their mother/father to RPS had been given a diagnosis/label of GOR/GORD.
  • Maternal anxiety appears to have the strongest association with having a baby admitted in the first year following birth with GOR/GORD.
  • A maternal admission with documented (especially anxiety) increases likelihood of a diagnosis of GOR/GORD in the infant nearly fivefold.

The compelling research also painted a picture of these mothers, who had a baby admitted to hospital and also had GOR/GORD documented, as more likely to be:

  • Australian-born;
  • Having their first child;
  • Giving birth in a private hospital, via ;
  • Having a pre-term or early term infant (37 or 38 weeks);
  • Having a male infant, who spent time in the NICU; and
  • Suffering from a psychiatric condition (most commonly anxiety).

Professor Dahlen says the new research on reflux calls for better support for women caring for new babies, at what can be a stressful and at times lonely journey.

"A cycle of anxiety in the mother and unsettled behaviour in the baby, leads to more anxiety in the mother and therefore a more unsettled baby," says Professor Dahlen.

"This does not mean that there is not a legitimate medical issue with the infant, or that the symptoms of reflux are in some way imagined. But it may mean that the medical issues are exacerbated when the mother is not coping."

Gastro-oesophageal reflux (GOR) is a common condition in infants. Symptoms include frequent spitting up; interrupted sleep; fussiness during or following feeds; constant or sudden crying; irritability and back arching.

Gastro-oesophageal reflux disease (GORD) is a chronic condition, with symptoms that include pain; breathing difficulties; swallowing dysfunction; frequent vomiting, choking and gagging; excessive weight loss; and delayed development.

Professor Dahlen says reflux is a common condition that should rarely require further investigation or treatment – yet rates of GOR/GORD diagnosis and treatment are significantly increasing and these treatments are not without effect on the child's longer term health.

Professor Dahlen says the research is telling us that a GOR/GORD diagnosis, particularly when some of these other factors are involved, should raise a red flag to health professionals.

"If health professionals delved a little deeper, they would find that it may be the that actually need help – and sometimes, there may be better ways to deal with the issues without the need for anti-reflux medication," she says.

Professor Dahlen says the very last thing we want to do is cast any blame on women.

"We focus so much on birth as a medical or increasingly a surgical event, and not enough on how women are coping. This research tells us that ignoring this is to the detriment of women, their and families.

"The medical community needs a rethink on this complex issue and take a more holistic approach. We propose a new way of approaching the GOR/GORD issue that considers the impact of early birth, caesarean section, and maternal mental health/ anxiety."

The team of researchers who undertook this study are now moving forwards with research into how to better support women who are anxious and what contributes to women's .

Explore further: Women having a baby by IVF are at increased risk of reflux disease after birth

More information: Hannah Grace Dahlen et al. Gastro-oesophageal reflux: a mixed methods study of infants admitted to hospital in the first 12 months following birth in NSW (2000–2011), BMC Pediatrics (2018). DOI: 10.1186/s12887-018-0999-9

Related Stories

Women having a baby by IVF are at increased risk of reflux disease after birth

August 10, 2015
Women who give birth to babies conceived by in-vitro fertilisation (IVF) are at increased risk of experiencing long-term symptoms of gastro-oesophageal reflux disease (GORD), according to the results of a study published ...

Surgery most effective for persistent heartburn and reflux

April 19, 2013
(Medical Xpress)—Surgery is more effective than medicine at providing relief from the symptoms of persistent heartburn and reflux, a University of Aberdeen-led study has found.

Severe acid reflux: Stomach wraps effective in short to medium term

March 16, 2010
Stomach wrap operations may be more effective than acid suppression tablets in the treatment of severe acid reflux, according to a new Cochrane Systematic Review. The study shows a more pronounced improvement in symptoms ...

Surgery for gastro-oesophageal reflux disease found safe

March 21, 2016
A new analysis indicates that death rates and the need for additional operations following laparoscopic surgery for gastro-oesophageal reflux disease are very low.

Obesity boosts gullet cancer risk 6-fold

October 11, 2007
Obese people are six times as likely to develop gullet (oesophageal) cancer as people of ‘healthy’ weight, shows research published ahead of print in the journal Gut.

Alarming rates of depression for parents of babies born before 30 weeks

July 19, 2016
A study that will be published in JAMA Pediatrics showed that more than one in five parents of infants born very preterm still show symptoms of depression and anxiety six months after birth.

Recommended for you

Breastfeeding protects infants from antibiotic-resistant bacteria

October 18, 2018
A recent study completed at the University of Helsinki investigated the amount and quality of antibiotic-resistant bacteria in breast milk and gut of mother-infant pairs. The findings have been published in the journal Nature ...

Inflammation in the womb may explain why some babies are more prone to sepsis after birth

October 9, 2018
Each year 15 million infants are born preterm and face high risks of short- and long-term complications, including sepsis, severe inflammation of the gut, and neurodevelopmental disorders. A new report in the American Journal ...

Dummies not to blame for common speech disorder in kids

October 9, 2018
New University of Sydney research shows bottles, dummies, and thumb sucking in the early years of life do not cause or worsen phonological impairment, the most common type of speech disorder in children.

'Genes are not destiny' when it comes to weight

October 9, 2018
A healthy home environment could help offset children's genetic susceptibilities to obesity, according to new research led by UCL.

Old drug could have new use helping sick premature babies

October 8, 2018
Researchers from The University of Western Australia, King Edward Memorial Hospital and Curtin University are investigating whether an old drug could be used to help very sick premature babies.

Insufficient sleep associated with risky behavior in teens

October 1, 2018
Adolescents require 8-10 hours of sleep at night for optimal health, according to sleep experts, yet more than 70 percent of high school students get less than that. Previous studies have demonstrated that insufficient sleep ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.