Advice About Reflux in Babies

Acid reflux in babies is similar to heartburn in adults.
This is how it happens:

When your baby eats and drinks, all that nourishment makes its way down to the stomach by way of the esophagus, a tube that joins your throat to your stomach. The esophagus doesn’t simply let the food and drink fall to the stomach. Rather, it actively pushes it toward its destination.

At the spot where the esophagus and the stomach join, there’s a little ring called the lower esophageal sphincter (LES). It’s like a little digestive gatekeeper that opens up when you swallow to allow the contents of your bites and sips into the stomach. It should then close up to ensure that that which is in, stays in. Food traffic control.

When it comes to acid reflux, however, the LES doesn’t close properly. The result? The contents get confused and go back the same way they came.

While this can happen to all of us, reflux in babies is more common because their digestive tract is not as developed. In fact, it’s really common in babies, as any mama who has made the grave error of putting on their favorite outfit before a feed can attest. (What goes down often seems to come up.)

The simple spit-up is not a cause for concern. More formally known as Gastroesophageal Reflux (GER), it occurs daily in about 70 to 85% of babies by the age of 2 months and usually doesn’t last much beyond 14 months.

That’s GER. Gastroesophageal Reflux Disease (or GERD) in babies is more of a cause for concern.

So what are the reflux symptoms babies experience that you should worry about? Let’s take a look.

In this article: 📝

Difference between GER and GERD in babies

Babies like to have a good spit-up after meals. Often. Newborn reflux can be a totally normal way for them to show their appreciation for the deliciously packaged nutrition you are providing for them.

However, if that spit-up is severe and accompanied by other symptoms, it can be a sign of the more serious type of baby acid reflux that requires medical attention.

Baby reflux symptoms

How do I know if my baby has reflux? Here’s the breakdown.

Symptoms of GER in infants

The main symptom of GER is spitting up after a feed. This is normal in the first 14 months or so, and, provided it’s not too excessive or frequent, it’s generally not a cause for concern.

Symptoms of GERD in infants

GERD can cause a range of concerning symptoms beyond spitting up. These include:

• Fussiness and frequent crying before, during, or after feeding time
• Refusing food
• Frequent vomiting and/or projectile vomiting from spitting up really forcefully
• Gagging or choking
• Not putting on weight
• Pauses in breathing
• Arching their back during feeding as a response to pain they are feeling
• Spitting up any strange fluids (green, red, bloody, dark brown)
• Any trouble breathing
• Chronic coughing
• Turning blue. This is also known as cyanosis

If you are concerned about any of these symptoms, give your healthcare practitioner a shout as soon as possible.

Causes of acid reflux in babies

First thing to know: you’re not doing anything wrong.

Acid reflux in babies results from their tiny little digestive tracts not being in full operation. Remember the LES? That ring of muscles between the stomach and esophagus that’s not closing properly? That’s what’s causing the reflux.

GERD occurs when the lining of the esophagus is irritated and sometimes damaged, by the acid that comes up.

Because reflux is a result of a digestive tract that’s not in full swing yet, being born prematurely can be a factor.

Luckily, there are some steps you can take to minimize acid reflux in babies and help your little one’s food go in the right direction.

Treatment of acid reflux in babies

Before we go any further, if your baby’s symptoms are serious and/or you suspect that it is GERD and not GER, talk to your healthcare provider. While there are steps you can take to minimize reflux in babies, some cases require urgent care.

Your doc may refer you to an ENT (Ear, Nose, Throat) specialist. While it’s not recommended to use medication for reflux in babies, it can be an option for more serious cases. Also, in very rare cases, surgery might be necessary to tighten the LES to prevent future reflux—but this is usually only done in cases where reflux is causing breathing problems and/or your baby is not gaining enough weight.

Right. Now onto what you can do from home in milder cases:

How can I help my baby with reflux?

Here are some steps that might help you out with the burn:

• Turn your baby into an upright citizen. Literally. If you can, get your baby into an upright position for feeding, and then keep them upright for about 20 minutes afterward, if possible. But:
  
• Say NO to sleep positioners (also called nests or anti-roll products). Intended to keep your baby’s head upright, they have been warned against by the FDA because of their connection to SIDS (Sudden Infant Death Syndrome)**.
  
• Small meals, often. Rather than big feeds, opt for frequent feeds. This makes it a little easier for that digestive system. It’s the same advice given to adults who experience heartburn.
  
• Get your baby’s burp on. Burping your baby frequently may help with acid reflux.
  
• Change up the bottle. For formula-fed babies, you might want to look at changing up the teat type.

And finally:

Baby Reflux FAQs

Does a pacifier help with reflux?

This is a complicated one. A recent study has shown that babies who use pacifiers appear to have less frequent and shorter periods of acid reflux. The reason? Pacifiers may stimulate saliva and the downward push of the esophagus, both of which may help to get fluids back into the stomach sooner rather than later.

However, doctors are still not recommending pacifiers as a treatment. Research is in its early days so it’s still too soon to tell. Added to this, pacifiers come with a whole bunch of other issues that can cause dental problems and breastfeeding woes.

Might be best to opt for other methods or talk to your doc about whether pacifiers can form a part of your treatment.

Does gripe water help with reflux?

Not according to the science.

Gripe water is contentious. The WHO advises that you shouldn’t give your infant anything other than breastmilk or formula to babies younger than 6 months as other substances can play all sorts of havoc in their tiny bodies.

Gripe water is one of these.

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