It is usual for babies to “spit up” milk during their daily routine. Spitting up milk is also known as gastroesophageal reflux (GER). Infants often experience reflux, which is perfectly normal.
Causes
The lower esophageal sphincter is a muscle at the lower end of the food pipe. During digestion, this muscle relaxes to let food into the stomach and contracts to prevent food and acid from entering the food pipe. There is a risk of liquid flowing back into the food pipe if the muscle does not completely close. The sequence occurs in all people, but it is more prevalent in infants under one year of age.
Regurgitation, or reflux, is common in infants between 3-4 months of age. Some infants regurgitate at least once a day, and some infants regurgitate with all or most feeds. After an infant reaches the age of 18 months, the muscle controlling food flow matures, thereby decreasing regurgitation rates.
It’s possible for infants to suffer from reflux due to a more serious condition, including:
- Intolerance of certain foods
- Eosinophilic esophagitis: A buildup of white blood cells inflaming the tissues of the esophagus
- Pyloric stenosis is a medical condition affecting babies that prevents food from reaching the small intestine
- GERD (gastroesophageal reflux disease)
Helping your baby cope with reflux
Changes in your baby’s feeding routine can reduce reflux symptoms. You might try the following:
- If possible, continue breastfeeding since breastmilk is easier to digest.
- During a feeding, make sure your baby takes breaks. Consider having a responsive/paced feeding approach if you’re bottle-feeding.
- Gently burp your baby throughout the feeding.
- Feeding your baby more frequently but shortening the feeding time.
- Lifting your baby’s head up above his or her bottom during feeds.
- Keep your baby upright for a few minutes after feeding.
- If you can, change your baby on their side so that their legs aren’t lifted up toward their stomach.
- Getting your baby off dairy might be necessary if your baby is allergic to cow’s milk protein. Your doctor may recommend that you use a special formula that partially breaks down cow’s milk if you are formula feeding.
- If your baby is formula-fed, your healthcare professional may suggest using a thickened or anti-reflux formula.
Treatment and diagnosis
Reflux can usually be diagnosed based on a baby’s symptoms, and no tests are needed. Reflux in babies does not usually require any specific treatment, though you may find the feeding suggestions above helpful. If a baby cries uncontrollably or is in obvious pain, an anti-reflux medication may be prescribed.
Symptoms that don’t improve with these adjustments may need a feeding assessment to rule out other causes. If a healthcare professional believes they could be helpful, an endoscopy, pH monitoring, or barium swallow test can be performed. Some babies with underlying medical conditions, like cerebral palsy, may also require surgery.
Final thoughts
It can be very frustrating for babies to experience reflux, and rarely one step is enough to resolve the issue. Each baby is different, so some of these tips may work better for some babies.
There are various treatment options for babies experiencing reflux, and it usually improves as they get older. Always consult your pediatrician if you have any questions about your baby’s health, no matter how seemingly small.
