Reflux, also known as possetting or spitting up, happens when the milk your baby has swallowed comes back up into his throat. Reflux in babies describes those bouts of spit-up that many babies experience. When babies occasionally spit up but otherwise are comfortable, happy and growing well, they may have gastroesophageal reflux.
It’s natural and you don’t have to worry about your baby if they’re bringing up their feeds. Reflux is messy and may be frustrating, but it’s normal for babies and isn’t usually a sign of illness. Reflux is very common and will usually pass by the time your baby is a year old.
What causes reflux in babies?
First and foremost, all babies have some level of reflux. This is because their entire digestive tract is more immature than older children. The sphincter muscle that separates the esophagus from the stomach is often undeveloped. When your baby eats, the valve opens to allow the milk through, then closes to keep it in his tummy. As this ring of muscle is still developing, it doesn’t always work properly.
This means that when your baby’s tummy is full, milk and acid can come back up the food pipe, causing discomfort. Bear in mind that your baby’s stomach is still tiny, so he may not be able to have much milk without some of it coming back up. In a small number of cases, reflux can be a sign of a more serious problem, such as: allergy or intolerance, GERD.
What are baby reflux symptoms?
While symptoms may vary, here are some main ones to look out for:
- Crying or uncomfortable after eating
- Spitting up milk during or after feeds – this may happen several times a day
- Feeding problems such as coughing or choking
- Refusing to feed
- Arching back after eating
- Excessive crying, or crying while feeding
- Resistance to laying on back
- Gassy and/or foamy bowel movements
- Unhappy or seemingly uncomfortable in body
- Wheezing or breathing difficulties
- Frequent burps and hiccups
- Failure to gain weight
How is reflux in babies diagnosed?
Most babies with reflux don’t need any tests. It can usually be diagnosed based on your baby’s symptoms. In rare cases, the following tests may be done if your baby’s reflux is severe or persistent:
- Ultrasound scan
- Barium swallow
- Blood tests
Treatment of reflux in babies
For mild cases of acid reflux in babies, there’s not much you can do. Most need no treatment. Your best course of action is to try to prevent those spit ups. However, if your baby’s reflux is severe or troublesome, your doctor may advise:
- H2 blockers, such as Zantac and Pepcid (which reduce gastric acid production and keep stomach acid from backing up into the esophagus)
- Proton pump inhibitors, such as Prilosec and Prevacid (which totally shut down gastric acid production). Neither is commonly used, though.
How to prevent reflux in babies
Because acid reflux in babies is simply a mechanical issue, you can minimize the likelihood of spit-up with a few techniques:
- Burping your baby regularly throughout feeding
- Giving your baby smaller but more frequent feeds
- Holding your baby upright for a period of time after feeding
- Avoid unnecessary activity after feeding
- You could also try raising the head end of your baby’s cot. Your baby should still sleep on his back, but it may help if his head is slightly higher than his feet.