As a parent, you’ve probably heard the term ‘reflux’ before. But what exactly is reflux, and what steps can you take to help ease the condition in your baby?
All about Gastro-Esophageal Reflux
Gastro-Esophageal Reflux (GER) is a normal occurrence in healthy babies where the stomach contents push back into the oesophagus (swallowing tube). It is then swallowed back (“silent reflux”) or spit/vomited up. Most babies (40-60%) struggle with some degree of reflux because of their immature gut, fluid diets, and the fact that they are mostly lying flat. Symptoms of reflux can start in the first few days of life and are usually outgrown by 12-18months. These babies are often irritable after feeds can arch their backs, sleep for shorter stretches, and want to feed often as the milk soothes their throats. Most babies with reflux grow well, feed well, and do not have any danger signs. These babies are often referred to as “happy spitters” and do not need any specific medicine.
Your baby may have Gastro Esophageal Reflux DISEASE (GERD) if he or she:
- Is failing to thrive (not gaining weight, not reaching developmental milestones)
- Refuses feeds
- Has signs of esophagitis (painful inflammation of the oesophagus)
Treating a baby with reflux
Here are a few expert tips:
- Upright positioning (90°) for 20-30min after feeds. Babywearing keeps your hands free and keeps your baby happy and safe. Keep in mind that reflux pillows that elevate a baby’s head have not been proven to make a big difference. A rocker or car seat can worsen symptoms due to the scrunched-up position and increased stomach pressure.
- It helps to give smaller feeds more frequently. The total volume of formula for the day can be divided by 12 to give two-hourly feeds.
- Breastfeeding moms can feed on demand but try to soothe your baby in other ways if the previous feed was less than 2 hours ago. Remember that breast milk has a protective effect against reflux.
- Thickening of feeds. Studies have proven that thickening expressed breast milk can decrease the episodes of vomiting.
- Several formula milk brands offer an anti-reflux formula that is a thicker milk and helps to reduce symptoms of reflux.
- Avoid exposure to tobacco smoke as this can worsen the symptoms.
Medications to treat reflux
- Proton Pump Inhibitors (PPIs) are used to suppress the amount of acid formed in the stomach. It will NOT decrease the number of reflux episodes or the amount of vomiting, but it could make your baby more comfortable if there were inflammation and pain due to the acid. If your doctor prescribes this medication, it is important to decide after 2 weeks if it is really helping and reassess after 3 to 6months if it is still necessary. Remember that stomach acid is essential for your baby’s digestion and immune function, and suppressing it does have risks.
- Antacids such as Gaviscon® have been shown to provide some relief in reflux symptoms, and it is safe to give for short periods (less than 2 weeks).
It can be scary if your baby vomits all the time, and it creates mountains of washing, but take heart! These days feel long, but the years are short, and before you know it, your child will be waving goodbye on their first day of school (without vomiting all the milk from their morning porridge.)
Red flags in a vomiting baby: A visit to the doctor is in order if your baby has the following symptoms:
- Recurrent projectile vomiting (when the vomit hits the other side of the room)
- Yellow bile or blood-stained vomiting
- Fever
- Distension or pain of the stomach
- Constipation or diarrhea
- Any seizures, abnormal movements, or abnormal head size
- Recurrent lung infections
