Four Answers to the Most Common Questions About Managing Reflux in Babies

Babies spit-up. That is just a part of their job. But when the spit-up causes other health issues, it can become a bigger concern for parents. 

Gastrointestinal reflux (GER) can happen to anyone, at any age. It happens when the contents within the stomach back up into the esophagus. In an infant, this causes them to spit-up. But unlike normal spit-up, reflux contains acids that can cause a burning sensation throughout the chest, neck, and throat. This can become uncomfortable for some babies, which can lead to other issues. 

Why Does GER Happen in Babies?

Between the esophagus and stomach, there is a ring that opens when swallowing, but remains closed any other time. The ring is called the lower esophageal sphincter (LES). In babies, this ring is sometimes not fully developed, allowing the content of the stomach to back up into the esophagus. 

Is it Reflux or Just Spit-up?

New parents are taught to burp their babies after feeding. The reason for burping them is to release some of the air that is swallowed during feeding, which can result in them spitting up or becoming gassy. Just because your child spits up after a meal doesn’t mean they have reflux. It is important to see your child’s pediatrician if they have any of the following signs. 

• Consistently spitting up forcefully (projectile vomiting)
• Lack of weight gain
• Spitting up blood, green or yellow fluid
• Crying or arching back during feedings
• Not eating
• Irritability after eating
• Swollen belly

How Long Does Reflux Last?

According to the American Academy of Pediatrics, GER typically begins around the infant’s first 2-3 weeks of life and peaks at 4-5 months. Symptoms typically abate in full-term babies around 12 months of age, when the LES fully matures. In rare cases, it can last longer than 18 months. 

How is Reflux Treated?

Depending on the child, their pediatrician may make the following recommendations to help ease the symptoms associated with GER. 

1. Smaller and more frequent feedings 
2. Keeping baby in an upright position for 30-minutes after a feeding
3. Burping baby at certain points during feeding
4. In bottle-fed babies, the pediatrician may recommend thickening their formula with a special type of cereal, however, this should never be done without a doctor’s recommendation. 

In some cases, especially if the baby is not gaining weight or continues to have feeding problems, they may be referred to a pediatric gastroenterologist. This specialist may recommend additional testing to determine the underlying cause of the reflux. 

More tips on addressing spitting up in babies can be found here.