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How Do I Know If My Baby Has Silent Reflux Or Colic?

How Do I Know If My Baby Has Silent Reflux Or Colic? - Babe in Dreamland

We are so prone to labelling babies with colic when they cry inconsolably or become unsettled for no apparent reason.

I reckon it is one of the top 3 parent’s justifications for these outbursts, alongside teething and tummy problems.

After all, colic commonly occurs in newborns and up to 6 months-old babies.

And the chances are – it is colic indeed, especially if the baby is fussy in the evening. The outbursts last for a few hours and happen again every day. There is not much we can do with it. Just wait it out, and it will pass on its own.

However, sometimes it might not be colic – but a condition called silent reflux. And with this one, you may need to do something about it.

So, here is what you need to know about silent reflux and how you can tell it apart from colic.

How Do I Know If My Baby Has Silent Reflux Or Colic?


The one thing silent reflux and colic have in common is an intense outburst of inconsolable cry that last over an hour and keeps reoccurring every day or so. There is, however, one fundamental difference between the two: colicky babies are healthy, whereas silent reflux babies show symptoms. These may include a sore throat, chronic cough, hoarse voice, frequent colds, congestion and ear infections, and trouble breathing and eating. Babies with silent reflux may require medical treatment, whilst colic will go away by itself.


What is A Silent Reflux?

Silent reflux has all symptoms associated with gastroesophageal reflux disease (GERD), except spitting the milk.

Reflux is nothing more than a backward flow of the stomach content towards the throat, causing an unpleasant burning feeling in the chest and trouble swallowing.

It typically occurs in newborns, due to the immaturity of the muscles between the stomach and the tube carrying the food down (esophagus) that cannot hold the stomach content down. And since babies are on a liquid diet only and spend most of their time lying horizontally, the content of their stomach can easily flow out of it. (Gravity won’t hold it down in a horizontal position either).

Now, if the pressure is large enough, the baby might spit up or vomit the milk, or if the pressure is smaller, the baby may not vomit but may swallow it back.

And this is called silent reflux.

Because of the lack of vomit or spit-up, silent reflux (or laryngopharyngeal reflux) can be challenging to spot and recognise. Hence, it can often be misdiagnosed as colic.

Because all other symptoms are so similar between the two conditions – most notable – loads for inconsolable crying for no obvious reason.

Furthermore, babies with silent reflux often keep growing well and put on weight steadily, as opposed to babies suffering from “normal” reflux, who often “fail to thrive” due to excessive vomiting.

Silent reflux, on the other hand, is a much more severe condition than colic, and can have long-term complications, such as throat irritation or damage.

So, it’s crucial to understand (and look out for) the difference between colic and silent reflux and treat it appropriately.

Symptoms Of Silent Reflux

Stomach acid is typically present there because it is vital for digesting food. So everyone has it, including babies.

But when highly concentrated stomach acid travels up and down in the baby’s digestive system–it can accumulate in the throat and cause a burn of sensitive soft tissues – leading to a tremendous pain. Hence the inconsolable crying.

Other symptoms of silent reflux may include:

  • Sore throat.
  • Swallowing after feeding when no there is no milk in the baby’s mouth to swallow.
  • Nasal congestion and noisy breathing.
  • Chronic respiratory condition, including cough.
  • Reoccurring ear infection caused by middle ear fluid build-up.
  • Trouble breathing or pause in breathing.
  • Choking or gagging.
  • Excessive drooling, which may appear like they are teething
  • Refusal to eat.

Although reflux should subside over time, particularly once your baby starts solids, you can adjust the feeding routine to make the symptoms more bearable for your baby in the meantime.

I covered this subject in my post: How Can I Help My Baby With Acid Reflux?

Except for the changes in feeding routine, your baby might need some medical treatment, such as proton pump inhibitors or H2 blockers. But the doctor prescribes these upon diagnosis of silent reflux in your baby.

LIVING WITH A SILENT REFLUX BABY

What Do Silent Reflux and Colic Have in Common?

First and foremost, colicky babies and those with silent reflux cry.

It is intense crying that may seem like an expression of discomfort and pain.

The crying lasts for more than an hour and is really difficult to soothe

Other signs include typical signs of discomfort, such as:

  • Arching their back and going rigid and tense.
  • Irritability and fussiness.
  • Bouts of screaming and crying.
  • Grimacing on the face.
  • Sleep disturbance.
  • Clenched fists.
  • Passing excessive gas.
  • Interrupted sleep.

Because of the crying and physical signs of discomfort, silent reflux and colic can easily be mixed-up.

So, it’s important to pay attention to a few subtle details.

So How To Tell Apart Silent Reflux From Colic?

First of all, colicky babies don’t have any health issues. They eat well and grow well. No problems except for high-pitch, intense, and lengthy crying episodes.

However, babies who suffer from silent reflux will show clear signs or consequences of stomach acid build-up at the back of their throat.

So, things like hoarse voice, “barking” chronic cough, noisy breathing, pause in breathing, gagging and frequent hiccups. And these symptoms will lead to asthma, frequent colds, stuffed nose and ear infections.

And that’s how you should be able to tell the difference between the two.

Each baby is different, and silent reflux may present with slightly different symptoms or a combination of symptoms.

In any case, if you think your baby may suffer from silent reflux, you should have them checked and professionally diagnosed by a doctor. And when necessary – treated with medications.

Final Few Lines

So, by understanding the differences between colic and silent reflux, you should be able to get a good idea of which condition your baby like has.

And finally – always trust your gut feeling.

You will know deep down if your baby is okay or if something isn’t quite right.

In this case, you should always seek medical advice.

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