Reflux – Causes and How to deal with it

Reflux is the phenomenon when babies spit up milk during or shortly after feeding. It is also called ‘posseting’. It is common in babies and usually, is nothing to worry about. Reflux is different from vomiting where the baby’s muscles contract forcefully to expel the stomach’s contents.

As their digestive system is still immature, most babies spit up often. This is because it is easier for the stomach’s content to go back up into the esophagus if it can’t be digested, making the baby passively spit up what they have just swallowed. Even though reflux is common, it still causes distress to some parents and they worry that something might be wrong.

It is important to realize that reflux is normal and is usually caused by the baby’s under-developed esophagus. When babies reach 12-14 months, reflux should stop. The ring at the bottom of their esophagus is now fully developed and prevents the stomach’s content from flowing back out. But if reflux continues for your baby after 18 months, then you should seek a pediatrician. It is rare for reflux to be a sign or symptom of something serious like Gastro-esophageal Reflux Disease (GERD). This is an allergy related to milk consumption or blockage.

This article will discuss about different types of reflux, medication and tips you can follow to minimize this phenomenon in your baby.

Why Does Reflux Happen

Babies spit up when they consume too much milk too fast. This is common for babies who feed aggressively and very quickly. If the baby gets distracted often, looks around or is fussy while feeding, he may swallow air and spit up more often.

Here are a few statistics that apply to all babies, not just those that are breastfed.

Though reflux normally occurs right after the baby had been fed, it can also happen after a couple of hours.
50 percent of all babies aging 0-3 months have reflux at least once every day.
Reflux is most frequent in the period when the baby is 2-4 months old.
For most babies, reflux stops at around 12 months.

If you have a happy baby who is gaining weight, appears healthy and spits up without discomfort then reflux is nothing to worry about. It’s more of a laundry issue due to the clothes they’ll go through in a day, than a medical issue in this case.

What could be the Problem?

If reflux is frequent, and is accompanied by discomfort to some extent, then this can signal an underlying problem. Your baby could have Gastro-esophageal Reflux Disease, an allergy or a blockage that might be causing frequent reflux.

Gastro-esophageal Reflux Disease (GERD)

A small percentage of babies repeatedly bring up milk after feeding and feel discomfort while it happens. This may be a case of GERD, which is a more serious long-term form of reflux. There is a ring at the bottom of the esophagus that acts like a valve. The valve is in place to prevent the backflow of acid and the stomach’s content into the esophagus or food canal. In GERD, this valve and the muscles related to it are weak and they relax when they shouldn’t or they do not close properly. This causes the acidic food in the stomach to flow back and touch the esophagus, irritating its lining.

GERD is more common in:

Premature babies
Babies who are born with lower weight than average
Babies who have muscle or neural disorder like cerebral palsy
Babies who are allergic to cow’s milk

As infants grow older, they develop the esophageal sphincter that keeps the stomachs content in check. Hence, around 18 months, babies grow out of this reflux.

Silent Reflux

Some babies with GERD do not experience spitting up. Instead, the stomach’s contents reach the esophagus and are swallowed again, causing pain but no spitting up occurs. This is called silent reflux and should be handled by taking appropriate measures.

Allergy

Your baby could be allergic to formula milk or cow’s milk that could be causing excessive reflux. Telltale signs include skin rash, vomiting and diarrhea. You could try cutting cow’s milk from their diet. If you breastfeed, then you should eliminate cow’s milk from your diet as well. If after 2-3 weeks, reflux does not get better, then allergy is most probably not the reason. You should seek a pediatrician in this case.

Blockage

Though it’s rare, but it is possible that your baby’s esophagus may be blocked. A blockage in the food canal might be the cause of reflux. The esophagus may be narrow, known as esophageal stricture, or there may be blockage between the stomach and small intestine. A trip to your general physician is in order if all else fails.

Tips to help your baby’s reflux

Here a few handy tips to ease your baby’s reflux.

Throughout feeding, burp your baby frequently
Refrain from overfeeding your baby. Some babies prefer to feed little but they feed often. Don’t force them to consume more milk than they want to
Try not to give milk too quickly to your baby. This can cause regurgitation
After feeding, hold your little one upright for some time so they digest their feed easily

Other habits that might help include raising your baby’s head a little while they sleep. Place a pillow under the mattress where they rest their heads. Make sure they sleep on their backs.

Vomiting

It is common for babies to occasionally vomit. If the vomiting persists for more than two days, then it is something to be concerned about. It can cause your baby to become severely dehydrated which can lead to more serious issues.

If your baby is less responsive, not eating well and not their normal self during vomiting, then seek medical help immediately.

The most common causes of vomiting in babies can be gastroenteritis, food allergies, infections or food poisoning.

Medications

Do not try to self-medicate your baby. Medications in cases of reflux are very rarely required and their benefits are not significant either. In cases of persistent reflux, silent reflux or vomiting, contact your care provider immediately and get your baby checked and diagnosed properly. You may get referred to a pediatrician who will be better qualified to treat your baby.