The Mystery of Silent Reflux

When “colic” is something more

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“She will not lay on her back.”

I remember repeating this to her doctors and to everyone I knew, desperately waiting for someone to say, “This is why,” and “This is what you do.” That advice never came.

Babies sleep in bassinets and then, when they are older, cribs…right?

In our case, wrong.

My baby spent very limited time in her bassinet from the very beginning, even in the hospital. Her legs were up in the air 99% of the time, and she constantly grunted and made throat-clearing, scream-like noises whenever she was on her back. The doctors were not concerned and told us she was “just stretching” from being cramped in the womb.

Stretching while sounding deeply uncomfortable? That seemed strange to me, but I trusted the professionals. I was a new mom.

As the days passed, her discomfort only grew worse.

She never spent a single full night in her bassinet. Every time we attempted to lay her on her back, the discomfort was immediate and obvious. We tried different bassinets, different pads, swaddling and no swaddling, white noise, singing, patting, rocking — everything. Nothing worked. Absolutely nothing.

From the night she was born, my husband and I took shifts holding her upright through the night. That remained our reality until very recently — but I’ll circle back to that.

The only way she could relax enough to sleep was being held upright. It was never simply about wanting comfort or contact. It was always about the exact position of her body. At one point, even the slight angle difference between standing upright while holding her versus sitting down was enough to trigger what looked like pain episodes.

We truly felt like we were going insane.

Not only could our baby not sleep independently, but most nights and naps we had to remain standing because the angle had to be “just right.”

“This is NOT normal.”

I said that to myself every single day, and my husband agreed. We researched frantically, convinced that the doctors simply were not understanding what we were seeing at home.

“It’s just colic.”

That sentence became poison to my ears.

While researching, I kept seeing that many of her symptoms aligned with reflux, especially the inability to tolerate lying on her back.

“But she barely spits up,” I kept telling myself.

Then I stumbled upon silent reflux.

Everything suddenly clicked.

I felt relieved to finally find something that sounded exactly like what we were experiencing. But in reality, this was only the beginning of a very long road ahead.

As I continued researching, I started to suspect there was also an acid component to her reflux. It would explain the bubbling noises in her throat, the discoloration on burp cloths, and the intense pain she seemed to be in.

Her symptoms included:

• back arching
• body tension and stiffening
• constant throat clearing and grunting noises while on her back
• extreme fussiness
• crying for 4–6 hours straight almost every day
• hiccups
• excessive drooling
• scream crying
• painful episodes where her body would stiffen like a board
• bubbling noises in her throat
• choking during bottles
• choking on reflux that rarely came fully out of her mouth
• inability to tolerate any time on her back

One thing that made her case a little unusual was that feeding actually soothed her. Many reflux babies develop bottle aversions, but thankfully she did not. Drinking her bottle was often the only time she was calm, and she continued gaining weight appropriately.

Around 4 weeks old, I became convinced she had silent reflux. By 5 weeks, we convinced her pediatrician to prescribe famotidine (Pepcid).

For two days, she improved dramatically.

Then everything came roaring back.

We finished the three-week trial feeling devastated. I knew there was another medication option, but I was terrified.

“She’s only 8 weeks old, and we’re already talking about stronger medication?”

At 8 weeks old, we started the medication that would become a lifesaver for her until she was about 4.5 months old.

Between 8 weeks and 4.5 months, her day-to-day reflux symptoms improved significantly. However, she still could not tolerate sleeping on her back.

At 4 months old, we decided to trial soy formula in case she also had CMPA (cow’s milk protein allergy). We hoped it might help her sleep.

And then — for one glorious week — everything improved.

It was the perfect overlap:
her reflux was still well-managed medically, and her stomach was finally no longer severely irritated by cow’s milk protein.

For one week, we saw our happy baby.

Unfortunately, it did not last.

The following week, her reflux symptoms returned in full force, and she also began showing signs of a soy allergy.

“What on earth do we do now?”

At that point, she needed an increased medication dose because she had grown from roughly 10 lbs at 8 weeks old to about 15 lbs. After fighting with doctors, insurance companies, and pharmacies — and after being repeatedly given the runaround — we finally got her dose adjusted appropriately.

Again, she improved.

But by the time her CMPA was fully resolved around 7 months old and her gut had healed, she had gained even more weight and needed another medication increase.

The problem was that she seemed to require dose increases more quickly than her doctors were comfortable prescribing. At the same time, her symptoms were beginning to decrease in severity, especially now that the CMPA had been addressed.

By 8 months old, we decided to begin weaning her off her PPI.

Those two weeks were brutal.

But by 8.5 months old, she became a happy baby.

For the first time in her life, she started tolerating sleep on her back. We had six wonderful weeks where things finally felt normal.

Then, just after 10 months old, her reflux symptoms suddenly returned again.

We could not believe it.

It felt like a nightmare we could never wake up from.

“How could she be perfectly happy for six weeks?”
“How is this happening again?”
“Why her?”

My baby had been in some form of pain nearly every day of her life, and it felt unbearably unfair.

I did not want to restart a PPI because I knew we would likely end up trapped in another cycle of chasing her weight with medication dosing while battling breakthrough symptoms.

Thankfully, I had continued bringing my daughter to pediatric OT.

Without her OT, we probably would have skipped over a step we had previously tried without success: thickening her feeds.

The first time we attempted thickened feeds, she still had significant acid reflux, so although thickening helped reduce visible spit-up, it did not protect her esophagus from acid irritation.

This time, however, her OT ordered a swallow study.

That study changed everything.

We discovered that she medically required thickened feeds because of an unsafe swallow.

At that point, we were unsure whether acid was even involved in this latest flare because some of her symptoms looked different. The most noticeable change was that she would scream, stiffen her body, and make throat-clearing noises during those screaming episodes. We nicknamed it “Hulk Baby.”

Other familiar symptoms had returned too:

• body stiffening
• increased hiccups
• increased drooling
• refusal to sleep on her back

Her OT and SLP team made thickened feeds mandatory for safe swallowing. They also explained that if acid was not the primary issue this time, thickening alone might significantly help her reflux symptoms.

And here we are now.

Our 11-month-old is breaking her own sleep records on her back every single night.

For the first time, we truly feel hopeful.

We do not anticipate the acid component returning, and we finally feel confident that our daughter is continuing to heal and improve.

Recommended Facebook support group: Babies with Reflux and Silent Reflux