Infant Reflux

Infant reflux is extremely common and usually does not cause or indicate a problem. Gastroesophageal reflux (GER) happens during or after a meal when stomach contents go back into a tube that connects the mouth to the stomach. Uncomplicated GER occurs often in healthy infants and usually is not something to be concerned with.

Most infants with reflux are happy and healthy despite spitting up or vomiting often. Spitting up usually peaks at around 4 months of age and most babies outgrow reflux by the time they are 1 year old.

Chances are your baby’s reflux symptoms upset you more than him. If your baby is spitting up but continues to drink appropriate amounts of formula or breast milk and is gaining weight well, it is probably nothing to worry about.

So when should you be concerned? Although most infants have reflux, most do not have symptoms that should cause concern.

Symptoms that May Indicate Cause for Concern:

reflux baby
  • Vomiting with blood, green or yellow fluid or poor weight gain
  • Severe crying or irritability
  • Food refusal and difficulty eating
  • Breathing problems
  • Difficulty breathing
  • Repeat bouts of pneumonia
  • Chronic cough
  • Wheezing

Interventions to Prevent Infant Reflux:

  • Avoid overfeeding.
  • Don’t feed your baby again immediately after he spits up. Instead, wait until the next feeding.
  • Make sure your baby is taking normal size bottles or nursing the appropriate amount of time.
  • Thicken formula feeding with 1 tbsp of baby rice cereal per ounce. Since this will thicken formula you may need to try different bottles to find one that has a big enough hole in the nipple to enable your baby to suck formula from it. This is a controversial method and should be used cautiously if the baby is younger than 4 months old.
  • In formula fed infants, try a hypoallergenic formula for at least 2 weeks.
  • Keep your baby in an upright position for 30 minutes after meals.
  • Avoid tightly fitting clothes, diapers and elastic waistbands.
  • Avoid exposure to tobacco smoke.

If the simple treatments mentioned above are utilized, most infants will improve. If your baby’s symptoms are severe your pediatrician may recommend medication or consult with a pediatric gastroenterologist.

Common Medications to Treat GERD:

Acid Blockers: Acid blockers are a popular treatment for infant reflux. These drugs block the acid production in the stomach. Popular acid blockers include, Pepcid, Zantac, Tagamet and Axid.

Antacids: Antacids are commonly used to treat infant reflux. Antacids only treat the symptoms, so although your baby may feel better while taking the antacid, his actual reflux problem is not being treated. There are a variety of antacids on the market, many designed primarily for adults. Some popular antacids for infant reflux include Maalox, Milk of Magnesia, Mylanta, and Gaviscon.

Proton Pump Inhibitors: Proton Pump Inhibitors are also used for infant reflux. These medications work to shut down the pumps that produce acid in your baby’s body so that they will experience fewer symptoms. These drugs are effective. Some popular brands include, Prevacid, Prilosec, Nexium, and Losec.

The Child with Reflux:

Most infants will outgrow reflux by the time they are toddlers. If your child still has reflux, however, here are some lifestyle changes that may help them:

  • Eat small meals often.
  • Avoid eating 2-3 hours before bed.
  • Elevate the head of the bed 30 degrees. If the bed does not elevate, a few pillows will suffice.
  • Avoid carbonated beverages, caffeine, chocolate and high fat and acidic foods.
  • Avoid large meals before exercise.
  • Avoid exposure to tobacco smoke.

The whole family is affected by a baby or child with reflux. If you are concerned your baby’s reflux is not normal, speak to your physician about appropriate treatments.

If you need help determining if your baby's reflux is normal or not, or would like to use natural interventions such as diet, make an appointment with us.