Infants admitted to the two NSW residential parenting services Karitane and Tresillian within their first year for gastro-oesophageal reflux (GOR) or gastro-oesophageal reflux disease (GORD) had a strong association of maternal anxiety, according to a study undertaken by Western Sydney University.

While the focus group analysis discussed the reasons for the increase in GOR/GORD diagnosis in recent years, and the overlap between the parental social influences; the medical model of care; and the medical over-diagnosis and tendency to prescribe medications before treating underlying psychological factors, the data did show maternal health pre- and post- birth played a role in the rate of infant oesophageal, respiratory and sleep difficulties.

The study indicated that a maternal mental condition had the strongest correlation with GOR/GORD, increasing the likelihood of occurrence fivefold within the first twelve months of life.

Other findings included the presentation of GOR/GORD in babies is more common to mothers who are:
·         Australian-born;
·         Having their first child;
·         Giving birth in a private hospital, via caesarean section;
·         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)

This additional information suggests that the disturbance of the gut microbiome via caesarean section, and antibiotics administered in NICU could also be contributing factors to the infant GOR/GORD diagnosis.

However, maternal health and parenting resources showed the highest correlation in infant reflux symptom responsiveness once GOR/GORD presented.

Research leader Professor Hannah Dahlen from the University’s School of Nursing and Midwifery says,
“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.”

“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.”

Rather than blaming mothers for ‘fussing’ over their babies, this research provides even more reason to help women with their post-natal mental health. GOR is common in infants, and while distressing, it is a short-term condition. Over-treatment can contribute to delaying diagnosis and treatment for the more serious GORD, which is a chronic condition and can affect a child’s development.

“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 babies and families.”

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

“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,” she says.

The research team is now looking into the causes of maternal anxiety and emotional and psychological support strategies presented through midwives, neonatal nurses, and child and family health nurses.