Reflux in babies - what it is and how to deal with it

Baby health

Reflux in babies - what it is and how to deal with it

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Reflux in babies - what it is and how to deal with it

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Reflux is an incredibly common issue for babies. In this post, we’ll look at what reflux is, how you can help prevent it and what you can do to ease your baby’s discomfort if Bub suffers from it despite your best efforts.

Please note that the information included in this blog post is for informational purposes only. It should not be construed as medical advice.

What is reflux?

Reflux, or gastro-oesophageal reflux, is a condition whereby a person’s stomach contents rise back through the digestive system and into his or her food pipe or mouth. Adults and children can both experience reflux but it is particularly common in babies because the sphincter muscles that usually separate the esophagus from the stomach are not fully developed at birth.

When a baby has reflux, he or she will bring up breast milk or formula. Sometimes this stomach contents will spill out of his or her mouth. You may hear this referred to as ‘spitting up’, ‘posseting’ or ‘bringing milk up’. This is different from projectile-type vomiting.

Reflux tends to be more obvious in babies than in adults because babies spend so much time lying down and have a liquid diet. Babies also have shorter oesophagi.

Reflux is most prevalent in the first month of life and some babies regurgitate their milk or formula  more than four times per day. There is  some evidence to suggest that babies that are at least partially formula fed are more likely to regurgitate more and more often.

Types of reflux

Most babies have what’s called ‘simple reflux’. If a baby with reflux is   gaining weight at an acceptable rate and seems to be happy in all other respects, Bub probably has simple reflux. This kind of reflux doesn’t typically harm babies and most babies grow out of it.

Another kind of reflux is referred to as ‘silent reflux’. This is basically the same as simple reflux except that a baby with silent reflux swallows his or her regurgitated stomach contents, or it doesn’t get as far as his or her mouth. As a result, the only sign of this kind of reflux may be Bub’s discomfort when the acidic stomach contents is regurgitated.

'Reflux disease’ on the other hand, is more serious and it requires diagnosis by a medical professional with subsequent professional treatment advice. This type of reflux is uncommon. You might also hear this disease called ‘gastro-oesophageal reflux disease’ or GORD.

Signs your baby might be suffering from GORD include:

  • Bub isn’t  gaining weight at an acceptable rate
  • Bub brings up a large amount of milk or formula after many or most feeds - sometimes it may seem as if Bub brings up everything he or she drinks
  • Bub appears to be unhappy and uncomfortable after many or most feeds - Bub might seem to be in pain after feeds and he or she might cry a lot or arch his or her back after a feed; Bub may also be fussy between feeds
  • Bub might experience breathing problems such as coughing or wheezing
  • Bub may also have particularly disrupted sleep

Sometimes reflux is symptomatic of another condition. For example, reflux may be a symptom of a food allergy or intolerance.

When to consult a doctor

If you’re at all worried about your child it is always best to consult a doctor. If you suspect your baby may have GORD, especially if Bub isn’t gaining enough weight or is experiencing breathing problems, a trip to your doctor will be in order. You should also take your baby to a doctor if he or she:

  • vomits bile or blood (if your baby’s vomit isn’t just white/off-white but instead contains green, yellow or red fluid, or looks like it has coffee grounds in it)
  • seems to be having trouble swallowing
  • refuses to eat or drink
  • is frequently irritable and difficult to settle
  • has a fever

You should also take your baby to a doctor if you suspect your baby’s reflux is a result of a food allergy or intolerance.

Are their treatments for baby reflux?

Babies with simple or silent reflux don’t usually need any treatment. Babies with more severe problems may need some treatment. Treatment may focus on the underlying cause of Bub’s reflux. In some instances, a doctor may also recommend treatment with an antacid and possibly an alginate (which helps prevent regurgitation). You should never give these medicines to your baby except on the advice of your doctor.

Whether or not your baby requires treatment for his or her reflux, your baby may benefit from attempts to prevent reflux.

How to prevent reflux

Even though reflux is very common in babies, especially in the first month of life, there are some steps you can take to reduce your baby’s regurgitation:

  • Feed Bub in a more upright position
  • Continue to keep your baby in an upright position for about half an hour after each feed
  • Experiment with feeding your baby smaller feeds more often (so that Bub still gets the same amount of milk or formula overall)
  • Burp your baby regularly
  • If you’re bottle feeding your baby, make sure you’re using the right size teat for his or her age, size and level of development - a flow that is too fast will make reflux more likely

What not to do

Sometimes parents may be advised to raise their baby’s mattress or cot slightly when Bub is asleep to keep Bub’s head above the level of his or her feet. This   does not reduce reflux nor is it considered safe. In such an environment, there is a greater risk that Bub will slip down the cot and become covered by bedding.

Similarly, it is   not considered safe to prop your baby up on a pillow in an effort to reduce reflux.

The   Red Nose organisation, which aims for a “future where no child dies suddenly and unexpectedly during pregnancy, infancy or in childhood”, also notes that “the risk of sudden death when baby is in the tummy or side sleeping positions outweighs any benefits of tummy or left side positioning of babies” with reflux.

Parents are also sometimes advised to add cereal to a baby’s milk or formula to thicken it in an attempt to stop Bub from regurgitating it. You should consult a medical professional before doing this. You should also be aware this tactic is only   moderately effective in reducing the severity and duration of reflux.

How to cope with reflux

Even if you use the above strategies for preventing reflux, chances are your baby will probably still spit up some of the time. As a result, it pays to be prepared. So, here are some tips for coping with your baby’s reflux:

  • Always have a cloth with you - You’ll want to have a cloth on hand to mop up any regurgitated milk or formula during each feed, You’ll also likely appreciate having a cloth on hand to protect your clothes, and the surrounding furniture etc., when you’re burping your baby. Cloths used for these purposes are after called ‘burp cloths’. Here are some additional tips:
    • When you’re at home, stash muslin wraps, face washers and/or other cloths in all the spots in which you normally feed your baby. That way you don’t have to remember to carry one around the house with you.
    • If you have a favorite couch or other chair that you like to feed Bub in, cover it with a throw rug or sheet so it’s always protected. Having a spare sheet or throw rug is also a good idea so you have something to use when the first one is in the wash.
    • Keep at least one of these burp cloths in your nappy bag and travel change mat if you have one. That way you’ll always be prepared when you’re on the go even if you have to leave the house unexpectedly.
    • If you’re short on space in your nappy bag or pram, consider wearing a muslin wrap as a scarf when you’re out and about. There are some really pretty and stylish designs available so no one need know your trendy scarf is actually an emergency burp cloth.
    • If you use a muslin wrap or other large cloth as your burp cloth, whether you’re at home or on the go, it can double as a ‘bib’ for you. Just lay it over Bub’s clothes when you’re eating while also giving Bub a feed or a cuddle and it’ll keep crumbs and spills from soiling Bub’s clothes. This is especially handy when you’re eating something messy as it’s surprisingly difficult to eat without spilling messy foods when one hand is busy holding Bub.
  • Cover all the ‘seats’ your baby travels in - Babies tend to spit up whenever you can’t easily clean them up properly (thanks Murphy’s Law) so of course they’re going to spit up when you’re driving or when you’re walking them in their pram and you can’t get home any time soon. So, it can be helpful to have a washable cover for Bub’s car seat/capsule and a washable pram liner in Bub’s pram. Once again, have at least one spare of each so you’ve got backups for when they’re in the wash. And always make sure any covers or liners don’t interfere with the safe operation of your baby’s car seat/capsule or pram. Check the instructions for these items for further details.
  • Cover the back seat of your car - Babies don’t just spit up on their car seats/capsules. They also sometimes spit up on the back seat of the car on which their car seat/capsule is anchored. If you cover the back seat with a wipeable cover, you’ll be able to quickly clean up any messes. This kind of cover is also useful when Bub is older and can kick the seat with dirty shoes. It will also protect your seats from food and drink spills in the future. Once again, make sure any cover you choose to use does not interfere with the safe operation of your baby’s car seat/capsule.
  • Choose your babies clothes carefully - Dark colored clothes may hide food stains when children are older but while they’re little, it’s better to choose white and pale colored tops as these are less likely to show the stains from regurgitated milk and formula. This can be great when you’re away from home. Similarly, choose clothing that’s easy to wash. There are some really cute suits out there for newborns and young babies but they’re not always machine washable and you may not have the time or energy to wash clothes in any other way.
  • Always have spare baby clothes and a bag for stashing any soiled clothes - When you’re away from home with Bub in tow, always take some spare clothes for your baby with you, even if you’re just nipping to the supermarket for a quick grocery run. Again, Murphy’s Law dictates that Bub will spit up all over his or her clothes as soon as you think you’ll be right without spares. Spare tops or onesies are great for when your baby regurgitates a lot of milk. Onesies are probably your best bet though as they’re also useful if Bub’s nappy leaks too. Always carry a bag specifically for soiled clothes as well so you don’t have to clean out the nappy bag (or other clean bag) at the end of the trip. You can use plastic bags but if you prefer to avoid plastic bags or they’re no longer used in your area then a ‘wet bag’ is a great option. These reusable bags have a waterproof outer layer to prevent wet or dirty items from contaminating the clean items in the rest of your bag. They’re also useful for carrying dirty bibs for older children. Such bags are often used to carry wet swimmers home from the pool so look for them wherever swimwear is sold in your area. Alternatively, places that sell reusable nappies also usually sell them for people who use reusable nappies on the go.
  • Take spare tops for you too - If you’re going to be away from home for more than an hour or so, it’s a good idea to take at least one spare top for you as well just in case Bub misses his or her burp cloth. A spare top will also come in handy if Bub pees on you during a nappy change. This is always a risk if you have a boy but girls can pee a surprising distance too!
  • Get some support - Sometimes it helps to connect with others who know what you’re going through or you might just benefit from having someone to talk to about your experience. If this sounds useful, take a look at the  Living With Reflux website. Living With Reflux is a charity that specifically caters to the needs of families of children with reflux and GORD.

Share your story

Does your baby suffer from reflux? Or do you have a tip for preventing reflux or dealing with it that we didn’t cover? Let us know in the comments. We’d love to hear about your experiences.