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Jennifer L.W. Fink
Registered Nurse

Reflux In Babies

Wondering whether baby has reflux and what to do about it if he does? Here's the scoop.

What is reflux in babies?

Gastroesophageal reflux (GER, commonly simply called “reflux”) occurs when the stomach contents back up into the esophagus and out of the mouth, often causing babies to spit up.

Reflux can be serious, but most of the time, it isn’t. “Some babies are happy spitters; they keep down more than they're losing,” says Alanna Levine, MD, a pediatrician at Orangetown Pediatric Associates in Tappan, New York. “Reflux doesn't cause them any discomfort. Their parents just have to carry an extra outfit for both the parent and the child.”

“For other babies,” says Levine, “the liquid coming back up causes discomfort. They may be difficult to feed, or won’t feed because they hurt so much afterward, and they might not be gaining weight properly. Those are the babies that I’m likely to treat for reflux.” Babies with bad enough reflux to need treatment are considered to have GERD, gastroesophageal reflux disease.

What are the symptoms of reflux in babies?

Frequent spitting up after feedings is considered reflux. Spitting up, plus fussiness, poor feeding, blood in the stools or poor weight gain, could mean baby has GERD.

Are there any tests for reflux in babies?

Simple cases of reflux won’t require any testing. If your doctor suspects a problem, they may order a special test called esophageal pH monitoring, which measures the amount of acid present in your child’s esophagus. (When the stomach contents back up, stomach acid moves into the esophagus too.) The doctor might also order a series of X-rays called an upper GI series and/or an endoscopy, which uses a thin, flexible tube to examine the esophagus. Most of these tests are performed in a hospital.

If your child’s symptoms strongly suggest GERD, your doctor may start treatment to see if it helps before exposing your child to any invasive, potentially uncomfortable tests.

How common is reflux in babies?

Over half of all babies will experience some reflux, usually in the first three months of life. Only a few of them will develop a serious enough case of reflux to be considered GERD.

The good news is that most kids outgrow reflux. “Almost all kids will grow out of it by a year,” Levine says. “Practically speaking, most kids stop spitting up by 10 months.”

How did my baby get reflux?

Chalk it up to an immature digestive system. “There's a valve between the esophagus and stomach that prevents the food and drink from going back up. This valve is not as strong in children as it is in adults, so often the liquids that they're drinking will go back up from the stomach into the esophagus,” Levine says.

What’s the best way to treat reflux in babies?

Changing your feeding practices might help. Offer baby small, frequent feedings (versus larger, spaced-out ones) and keep her in an upright position. Burp her frequently — at least halfway through a feeding and again at the end. “You definitely want to keep your baby upright for half an hour after a feeding because you let gravity help you keep the stomach contents down,” Levine says.

If that’s not enough to solve the problem, you might need to thicken baby’s formula or breast milk — but this is only to be done under your doctor’s guidance! Baby cereal can be used to thicken formula or breast milk; there are also some pre-thickened formulas on the market.

Babies who aren’t gaining weight properly may need medication. Two different kinds of meds are typically used: H2 blockers such as Zantac and Pepcid (which keep stomach acid from backing up into the esophagus) and proton pump inhibitors such as Prilosec and Prevacid (which decrease the production of stomach acid).

What can I do to prevent my baby from getting reflux?

You can’t completely prevent reflux, but giving your baby frequent, small feedings and keeping her upright after feedings may help.

What do other moms do when their babies have reflux?

“My son will be six weeks tomorrow. A couple weeks ago, he was diagnosed with silent reflux and was prescribed Zantac. It seemed to help, but the past few days, he’s been really fussy. At first I thought it might be a growth spurt, but now I'm thinking that the medicine has stopped working. He’s started exhibiting the old symptoms: crying, seeming to be in pain, arching his back/tensing his body, grunting and clearing his throat, making faces as if something is stuck in his throat and sometimes whimpering while nursing. I'm going to call the doctor first thing Monday morning. I wonder if they'll increase the dosage or switch to something else.”

“One thing that’s really helped my baby, as well as a couple of my friends' babies, is seeing a pediatric chiropractor. Not only does it help with reflux, but it can decrease hiccups and help make burping easier too. There are other benefits, of course, but those were my daughter’s main issues. It's not like an adult chiropractor where they crack baby's back — it's kind of hard to explain, but I'd definitely recommend seeing if you can find someone in your area. It's worked wonders for us!”

“We have my daughter’s mattress elevated at the one end by a book in her crib. And I have her sit up in my lap for half an hour after she eats.”

Are there any other resources for reflux in babies?

National Digestive Diseases Information Clearinghouse

American Academy of Pediatrics’

_The Bump expert: Alanna Levine, MD, pediatrician at Orangetown Pediatric Associates in Tappan, New York _