Unsettled 6 week old with reflux

QUESTION:
I would just like to find out and get some advice regarding my baby boy. He is now 6 weeks old, has been a dream child wakes 3-4 hourly for feeds winds easily and sleeps easily. Until the beginning of the week.... He suddenly takes forever at nights to settle. I am bottle-feeding and have been using the same bottles and milk from the beginning. He lands up screaming for at least 2 hours before he eventually passes out. I have tried to feed him but refuses the bottle, I have tries to swaddle him, changed his nappy, rocked he but it seems as if nothing helps. He stares around and arches his back, I wind him but there are no winds that come out, he doesn't seem to be pulling his legs up either. The time varies each night as to when he cries. It’s either at bedtime between 6-7, or at the 10 o clock feed or the 2 o clock feed. He seems to be WIDE awake. During the day none of the above occurs, he feeds, winds, plays and sleeps. No crying involved.
We have currently discovered that he has reflux, could it be possible that the reflux worsens at night? And why only now? He sleeps slightly elevated and is on reflux medicine including anti-reflux milk?
Please help, I really want to help my baby as he sees so distressed in these times. Look forward to hearing from you.

ANSWER:
This is such a tough time for you. Having an unsettled baby in the middle of the night is hard for everyone, because in addition to trying to sooth him, you will be feeling tired and your capacity will be low.

Reflux often only raises its head at this age and the reason is as follows. Many babies suffer from reflux – in other words they have milk curds and stomach contents (including stomach acid) coming up the oesophagus. For most babies this does not pose a problem at all and for the last few weeks this was true for your little boy. But for some babies, after a while the acidic stomach contents actually burn a little patch on the oesophagus and cause an irritation on the delicate membranes. This irritation is worsened by being over fed and by sleeping flat as the milk curds rise up the food pipe and lay on the oesophagus.

To manage the discomfort, I suggest you follow the advice of your doctor on introducing medication – this will start to work within a week of being used. Secondly, you should raise the head of the cot and finally nighttime feeds need to be handled with care:
1. Do not wake your baby at night for feeds
2. When your little one wakes, feed him in the dark swaddled
3. Only change his nappy if it is soiled, not if it is only wet.
4. After the feed, wind him for less than 5 minutes, even if a wind does not come up.

And finally keep calm and carry on – you are doing a great job in the face of some tough times.