Is it possible to sleep train a baby who has reflux?

Medical comes first, behavioral second

Reflux isn’t something sleep coaching treats. If your baby is in pain, arching, refusing feeds or not putting on weight, start with your pediatrician. Once the reflux is under management (via feeding changes, or medication if your pediatrician prescribes it), sleep becomes something you’re able to change. Plenty of reflux babies go on sleeping badly for behavioral reasons that sit on top of a medical issue that’s already controlled.

That remaining sleep problem can be fixed, and fixing it is Actually Sleeping’s work. Dr. Sam writes your baby’s plan with their reflux history in mind, and we coach you thoroughly before night one so you start out confident.

Safe sleep stays exactly the same

According to the American Academy of Pediatrics, babies with reflux should still be placed on their backs to sleep, and babies on their backs are no more likely to choke, even if they spit up. Your baby belongs on a firm, flat mattress in a crib, bassinet or play yard with no soft bedding. The AAP’s guidance:

• Raising the head of the crib doesn’t lessen reflux, and it may be unsafe.
• Infants shouldn’t sleep in inclined products, per the AAP, and there’s evidence a semi-inclined position may worsen reflux.
• Sleep positioners and nests are not recommended by the AAP.
• Car seats, swings and reclined bouncers aren’t safe sleep spaces. If your baby nods off in one, transfer them to their crib or bassinet.

Don’t follow any sleep plan that depends on inclines, wedges or positioners.

Why waking often continues once the reflux is under control

Reflux babies have usually been scooped up at every noise, and for good reason. For months many of them have fallen asleep upright, while feeding or in someone’s arms, because that kept them comfortable. The reflux settles, but the habits remain. Your baby still relies on that help between sleep cycles, so nights stay fragmented even after the pain has eased.

Where generic plans tend to fail reflux babies

An off-the-shelf plan is written for a baby with no medical history. With a reflux baby, the timing of feeds, the upright time before sleep and the speed of change all have to suit that baby. Move too quickly and a baby who has learned that crying signals pain may get more distressed. Step in too often and nothing shifts. Striking that balance for one specific baby is difficult to do from a book.

Our approach to reflux

Actually Sleeping works with reflux babies and NICU graduates. Dr. Sam, a Doctor of Pharmacy, builds the plan around your baby’s reflux history, feeds and temperament. We coach you bootcamp-style before the first night and check in 1:1 every day, adjusting the pace as your baby responds, and we coach naps until they’re solid. Your pediatrician remains the person for medical questions. Your custom plan sets how night feeds are handled, based on your baby’s age.

We guarantee the result: “We guarantee that your baby will sleep 8–12 hours through the night within 14 days of consistent, correct implementation of your sleep plan.” If it doesn’t happen, you receive a full refund. Hear from other parents in our video reviews.

If the reflux is controlled but sleep still isn’t, book a free consultation and walk us through your baby’s history.