It truly is astonishing how much there is to know about babies. From developmental and growth goals, proper feeding techniques, general caretaking, and ensuring your baby receives appropriate learning stimulation; it can be overwhelming! Common experiences, like unusual nappy contents and spitting up can cause even experienced parents to worry.
When it comes to spit up or infant reflux, rest assured that more than three-quarters of all babies experience this!
Reflux is extremely common in infants and babies up to one year of age. During an episode of infant reflux, the contents of the stomach are regurgitated up the oesophagus, the tube connecting the mouth and stomach. Most adults have experienced this and reflux is a common symptom of pregnancy. Unlike in adults though, most episodes of reflux in infants is not distressing or painful. In fact, infant reflux is more often distressing to parents than babies especially because it can be the end of your clothes or embarrassing in public.
Babies are susceptible to reflux starting in their first month, but most babies have stopped spitting up by 12 months. Reflux is so common because babies:
- Have a mostly liquid diet
- Spend much of their time lying down
- Have a shorter oesophagus
In most cases, reflux usually presents as milk dripping out of the baby’s mouth and usually occurs shortly after a feed. Commonly known as posseting or spitting up, this is nothing to be worried about. As long as your baby is gaining weight, seems overall content, and is eating well, reflux is just a social and laundry issue.
Is Reflux Normal for Babies?
Absolutely! Most babies will experience reflux several times a day within their first year (so don’t scrimp on towels!). Reflux usually occurs right after a feed and usually within two hours of eating. Reflux is most common in the first month of baby’s life, with about 75% of all newborns spitting up. By five months, this number reduces to about half of all newborns.
What Contributes to Reflux in Babies?
There are several things that may contribute to infant reflux, including:
- Too much milk and drinking too quickly. For breastfed babies, this may be due to an oversupply or an overactive let-down in mum
- Swallowing air while feeding, which is common in active, fussy, and distracted feeders and babies who have latched poorly
- Teething. Babies who are teething tend to produce and swallow more saliva than usual
- Overactive mucous production due to an illness or other irritation
When Will Babies Stop Spitting Up from Reflux?
Many parents quickly get tired of all the laundry that reflux causes. Most babies will have stopped spitting up by 12 months, with only about 4% of babies still experiencing reflux at that age. As your baby grows, their diet changes and their digestive system develops more fully. If your baby is older than 12 months, it may be time to discuss your baby’s reflux behaviours with your paediatrician.
Should You Talk to Your Pediatrician About Your Baby’s Reflux?
Infant reflux can seem like a serious problem. Aside from the mess, it can be uncomfortable for baby and you may worry that they aren’t getting the proper nutrition.
Most likely though, your baby’s reflux is normal. If your baby is gaining weight, has no respiratory problems, and does not seem to be in pain from their reflux, there is no need to worry.
Babies experiencing GORD should be seen by a professional. Although this condition is rare, it encompasses many symptoms and potential causes. If your baby is uncomfortable when spitting up, has bad breath, or is not meeting weight benchmarks, make sure you discuss your baby’s behaviours with your pediatrician.
What are the Symptoms of GORD in Babies?
While many people think of GORD as being a disease that affects middle-aged adults, babies can experience this uncomfortable disease, too. GORD is not particularly dangerous and affects only about 1 in 300 babies, so your baby is more than likely not experiencing it. Still, if you are worried that your baby may be living with GORD, evaluate him or her for the following symptoms and then discuss them with your pediatrician.
Babies experiencing GORD often display the following symptoms:
- Spitting up a large volume of milk after most feeds
- Unsettled feeding and post-feeding behaviour, including signs of pain or discomfort. This can also manifest as fussiness during feeding and rejecting the breast or bottle
- Underweight and missing weight goals
- Respiratory problems like persistent coughs, infections, and wheezing
Because these symptoms are not exclusive to GORD, so make a note of your baby’s behaviour and discuss with your pediatrician.
Is Reflux in Babies Caused By Feeding?
If your baby is experiencing reflux or symptoms of GORD, it can be tempting to blame yourself. It’s important to understand that infant reflux and GORD are NOT caused by how your baby is fed. It has been noted, however, that babies who are exclusively breastfed experience shorter bouts of GORD than partially breastfed or bottle-fed babies. Babies who are breastfed also tend to have fewer instances of reflux per day.
What Can Parents Do to Naturally Reduce Reflux in Babies?
Luckily, while reflux and GORD aren’t caused by anything you’re doing wrong, there are some simple lifestyle changes that you can implement to help baby be more comfortable. These easy tips can help your baby feed and digest more comfortably (as well as keep your clothes free of spit up!).
- If mum has an oversupply or overactive let-down reflex, consult with a doctor or breastfeeding consultant to manage this
- Babies should be held more vertically than horizontally during feeding and held upright after feeding
- Minimise air swallowing by working on proper latching and optimal positioning
- Many babies experience less reflux when fed smaller, more frequent meals
- Carrying babies in an upright position, as with a sling or other carrier
- Looser clothing and nappies reduce constriction around the belly, ensuring baby has enough room to expand during feedings
- Avoid jiggling your baby during and after feeding, which may induce reflux
- Cigarette smoke exposure should be eliminated, as this may cause reflux to worse
- Consider using a natural remedy that may help relieve reflux symptoms
- Mums who breastfeed and pump should avoid certain foods in their diets. Caffeine and cow dairy may cause reflux to worse in babies
- Observe your baby’s behaviour and tailor your feeding practices to her
- All babies should sleep on a flat, firm mattress on their backs clear of potential breathing obstructions like pillows and stuffies, even babies experiencing GORD.
Do Thickened Milk and Formula Help Babies with Reflux?
You may read or get advice recommending thickening your baby’s milk or formula to treat reflux. That’s because many believe that the “heavier” liquid stays down more easily. The Australian National Health and Medical Research Council agrees that thickened milk stays down more easily, but does not affect a baby’s GORD or reduce acid exposure. Therefore, thickened feed does not play a role in managing your baby’s GORD.
Discuss any changes you would like to make to your baby’s food with a pediatrician or pediatric nutritionist before implementing them. Thickened foods can have negative side effects, like slower digestion, constipation, and coughing, so most parents will want to avoid this. While thickened food does play a role in the treatment of other conditions and diseases, most babies will thrive on a proper diet of breastmilk and complete formulas.
Should Your Baby’s Reflux Be Treated with Medications?
While most reflux in babies is completely normal, many parents will want to treat or attempt to prevent reflux with medications. Most medications for reflux reduce stomach acid production, which lacks evidence in support of this being an effective treatment for GORD. Moreover, reducing stomach acid productions is generally inadvisable. Pharmacological treatment should only be undertaken under the advice of your doctor and is only advisable for a small number of complicated measure. Otherwise, reflux and GORD should be managed with the above lifestyle tips. Instead, you can try managing your baby's reflux with the above lifestyle tips or a specially formulated, gentle remedies.
Where Can Parents Find Support Resources for Babies with Reflux and GORD?
- Reflux Infants Support Association
- Australian Breastfeeding Association counsellor
- La Leche League Leader
You can learn more about some of our top tips for healthy babies at the Parenting Naturally Blog. If your baby is experiencing stomach issues, you may also be interested in learning about colic in babies and using Brauer Stomach Calm to help your baby with an upset tummy.