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Anxious mothers and an infant's risk of reflux

Does a mother's anxiety increase her infant's risk of reflux?

A recent Australian study showed that first-born infants of mothers with a mental health problem were nearly five times more likely to be admitted to hospital with reflux. This was especially the case if the mother experienced anxiety.

baby

Gastro-oesophageal reflux is a common problem in infancy, that is usually self-limiting and does not require any medical treatment. Even so, reflux can sometimes still be distressing for the infant and for its parents. Much more rarely, severe reflux can also cause complications, for example, for the infant's breathing, sleeping, feeding and general development. At this point the condition can be classed as gastro-oesophageal reflux disease (GORD).

The study found other factors associated with hospital admissions for GORD in babies, but the association with maternal mental health was the main new factor identified. However, the link between maternal mental health and admission for GORD is likely to be complicated. One reason for this is that the symptoms of GORD, such as constant crying or a sleeping difficulty, can be ambiguous and may result in a diagnosis of GORD that masks other problems. In fact, the authors claim that GORD is overdiagnosed and overmedicated in their Australian context and point to evidence of a similar situation in North America.

The ambiguous nature of the presenting symptoms of GORD leaves open the possibility that other factors may lie behind an infant's constant crying or sleep problem. The study authors speculate that it is in this area that a link with maternal mental health might be found. There are many studies now that indicate that perinatal parental anxiety or depression can have an effect upon their infant's capacity to regulate their emotions. Some of these effects may be biologic, whilst others reflect parenting behaviour.

Of course, an infant's chronic distress may in itself be a cause of poor parental mental health.

The other two key factors that this study identified as associated with hospital admissions for GORD were premature birth and caesarean delivery. In both cases the authors discuss biological reasons why these factors may increase an infant's risk for GORD.

The study suggests that an over-medicalised response to reflux can stop other issues being explored, including the nature of the mother infant relationship. Even where physical factors are the main cause of GORD, the effects of a chronic condition upon that relationship can be significant and may lead to longer-term problems.

This study is a useful reminder that support for the parent-infant relationship should always be placed at the centre of good perinatal care.

Reflux is very common and is usually not a cause for concern. Please see the NHS or NICE websites for UK-based advice and information. However, these sites tend to emphasise the physical problems associated with reflux, rather than highlighting the emotional context.

Gastro-oesophageal reflux: a mixed methods study of infants admitted to hospital in the first 12 months following birth in NSW (2000–2011)


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Welcome to ourNews, where we keep up-to-date with research and other news related to infant mental health. These articles can be of interest to both parents and professionals.
We are keen to know your views and so please do comment on our articles.
Is there a topic that you would like us to write about? Just send us a message via 'Contact us'.

ourAdvice, our other blog, has brief posts with advice for parents.

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