Having a newborn that’s spitting up more than 3x each day can become a hassle, or even worrisome! Let’s go over everything you could need to know about newborn reflux, newborn reflux signs, and the best breastfeeding positions for babies with reflux!
Further, we’ll go over some other effective methods for dealing with excessive spit-up and reflux. Plus, why you should avoid reflux medications unless they are necessary.
What’s Baby Reflux?
Reflux is also known as gastrointestinal reflux (GER) when bile (also known as stomach acid) flows up from the stomach and into the esophagus and irritates the esophageal lining.
Reflux occurs because a sphincter muscle at the end of the esophagus isn’t closing properly when the food arrives in your stomach.
This is very common in newborns because they are all born with underdeveloped systems, such as their immune and gastrointestinal systems.
Additionally, since newborn reflux is caused by underdevelopment, it is even more common in premature babies (babies born <37 weeks).
Does Newborn Reflux Go Away?
Yes, newborn reflux most often goes away after 2-3 months of your baby’s life.
Give your baby time to develop, avoid other causes of spit up mentioned below, and just keep using the tips provided to minimize your baby’s discomfort with reflux!
Newborn Reflux vs. GERD
GERD is known as gastrointestinal reflux disease, a more serious version of acid reflux. The distinction between reflux and GERD includes that GERD occurs two or more times a week.
Additionally, GERD is more commonly associated with regurgitation of food or bile, difficulty swallowing, breathing problems, and coughing — especially while lying down at night.
Common Causes of Spit Up
Some common and normal causes of baby spit up include:
- Rapid milk flow either from the breast or bottle
- Excessive movement after feedings
- Crying before a feeding (causing excess air in their digestive system)
Possible Causes of Excessive Spitting Up:
Before explaining and sharing more information on true reflux, I want to address other possible causes of your baby’s excessive spit-up.
- Breastmilk oversupply and/or a fast let-down can cause reflux-like symptoms and usually can be fixed with simple remedies and feeding methods.
- Overfeeding: Remember the definition of reflux explained above; If your baby is being overfed and has a belly full of milk, it can be more than their system can handle, causing it to come up more easily due to their weak lower esophageal sphincter.
To help prevent your baby from being overfed and experiencing spit-up or reflux, check out How to Feed Your Baby a Bottle the Right Way in: How to Introduce a Bottle to Your Breastfed Baby!
- Avoid “topping off” with formula if your milk supply is normal. This is another known cause of overfeeding.
- Food sensitivities: The most likely offender is cow’s milk products (in baby’s or mom’s diet). But please look into if there’s a breastmilk oversupply or fast let-down first before coming to the conclusion of a food/cow’s milk sensitivity, as it’s often misdiagnosed!
- Other things to check: if your baby getting anything other than breastmilk such as formula, solids (including cereal), vitamins (fluoride, iron, etc.), medications, or herbal supplements. Also, think about if there’s anything you started taking that may be causing more spit-up, such as medications, herbs, vitamins, iron, etc.
Is Newborn Reflux Dangerous?
If your baby is healthy, growing well, and always cared for closely, then newborn reflux isn’t a cause for concern.
However, if your baby begins lacking normal and healthy growth by struggling to gain weight or losing weight, then this is an appropriate time to contact their pediatrician about temporary medications for reflux.
The Truth About Medications for Babies with Reflux…
As I mentioned, currently, too many doctors seem to be prescribing medications for “reflux” too quickly. This study showed these medications, such as Ranitidine (also sold by the brand-name: Zantac), disturbs hydrochloric acid in a baby’s stomach, which aids in their digestive signals [1].
This acid also serves as a barrier against bacteria, fungus, viruses, roundworms, giardia (a tiny parasite/germ that causes diarrheal disease), etc. And most cases of reflux just aren’t often worth blocking with these medications, and they can sometimes cause more problems if it’s not severe reflux.
Does My Newborn Have Reflux?
Here are some signs and symptoms that your baby may have reflux:
- Inconsolable crying associated with feedings. But not from you, although, I know from experience that happens sometimes and you are not alone!
- Poor weight gain and/or weight loss
- Difficulty eating such as breast and/or food refusal
- Difficulty swallowing, hoarseness, chronic nasal/sinus congestion, chronic sinus infections, chronic ear infections
- Spitting up blood, or green/yellow fluid
- Sandifer’s Syndrome: A typical attack of Sandifer syndrome is when a baby’s back suddenly arches, they become stiff, and their neck and legs arch. Other expressions of the syndrome include nodding head movements, twisting or tilting of the head, or thrashing limbs.
- Breathing problems such as bronchitis, wheezing, chronic cough, pneumonia, asthma, aspiration, apnea, or cyanosis (a blueish color in the skin resulting from poor circulation or low oxygen).
Tips for Babies with Reflux
If your baby is spitting up frequently or has reflux, talk with your baby’s pediatrician about trying these tips:
1. Positioning
Position your baby in a semi-upright or sitting position (at a 30-degree incline) while breastfeeding or bottle-feeding. Remember to recline back, relax, and ensure your baby is tummy-to-tummy with you!
Beware that positioning your baby at a 60° incline, such as the posture of being in an infant seat or swing, has been found to increase reflux compared with the tummy down position [2].
2. A Calm Environment
Create a calm environment after your baby feeds.
Don’t worry about burping hard to help them; instead, use gentle pats, then put them into a wrap upright to help them digest better.
If your baby doesn’t seem to be burping when you’re trying, take a break and try again in 5-10 minutes with the same gentle pats. Don’t stress!
3. Babywearing for Reflux
As I mentioned above, babywearing is another tip I recommend! Many parents have found that babywearing can be helpful.
I find the Solly Wrap to be amazing, especially for little babies. But, if you’re looking for an affordable carrier where you can carry your baby in the front or the back, then I recommend the Infantino Carrier.
4. Avoid Overfeeding
One of the symptoms of overfeeding is reflux.
For more information, check out the “Possible Causes of Excessive Spitting Up” above!
5. Breastfeeding on Demand/ Suckling
Allowing your baby to use suckling on your breast anytime (aka allowing non-nutritive sucking and feeding on demand) can be very beneficial because suckling aids in gastric emptying, making your baby’s digestion much easier.
Another form of non-nutritive sucking for babies is a pacifier. Check out: “Should Your Baby Use a Pacifier?”
Remember: Rice Cereal in Bottles is NOT a Good Idea!
Putting baby cereal in your baby’s bottle will thicken the milk, which will probably reduce the amount of spit-up you’re seeing, but this still isn’t solving the problem.
Therefore, the baby may still be spitting up, but now it’s coming up like GERD, which is often associated with increased coughing, gastric episodes, and aspiration.
Furthermore, feeding rice cereal in bottles with breast milk or formula will slow your baby’s digestion and possibly make them fall into a deeper and longer sleep, which increases their risk of SIDS.
Breastfeeding Positions for Babies with Reflux
The key to perfect breastfeeding positions for babies with reflux, are positions where the baby is more upright to easily allow the breast milk to pass through the esophagus.
Furthermore, upright feeding positions give the baby more control on how much breast milk to have and when to stop when they are full to avoid accidental overfeeding.
Especially if the baby is under 3 months old, their suck reflex is involuntary.
Therefore, each suck facilitates a swallow, which facilitates another swallow, and so on until before you know it they sucked an overfilled bottle down, or too much breast milk from the breast!
Overfeeding can lead to spitting up, fussiness, rapid weight gain, and gagging or choking.
Overfeeding can be a dangerous cycle because it can lead to moms feeling like they can’t pump enough to keep up with their baby but that’s because that’s not how much the baby should be eating! If your baby is being fed properly using paced bottle feeding, you will feel confident that you can keep up with your baby.
1. Semi-Reclined Breastfeeding Position
Semi-reclined position, also known as ‘laid-back posture’ or ‘biological nurturing.’
- In this position, sit in a comfortable, semi-reclined posture.
- Drop your shoulders and lean your back into a supported, reclined position.
- Next, while leaning back, bring your baby to your bare chest with their tummy on yours (tummy to mummy!) and bring your baby’s cheek up to your breast.
In this position, your baby will be supported on your body with their head and body free to move.
This position, (along with the ‘Australian posture’) is useful if you have a large milk supply, oversupply, or a fast let-down because your baby will be able to move his or her head to manage the rapid flow of milk.
Additionally, in these positions, your breastmilk flow is working against gravity which is beneficial for your baby’s feeding under these circumstances.
One study from 2020 also found that “biological nursing significantly reduced the risk of breast problems including cracked and sore nipples” [1].
2. Australian Posture for Babies with Reflux
In this position, you will be “down under” your baby, lying on your back, and your baby will be supported on your chest.
This position along with the ‘semi-reclined nursing’ position is useful if you have a large milk supply, oversupply, or a fast let-down because your baby will be able to move his or her head to manage the rapid flow of breastmilk.
3. Koala Hold for Babies with Reflux
- Sit semi-reclined with your baby straddling your leg and facing your breast. If they can’t straddle your leg comfortably, keep their legs in between yours.
- Support baby’s head with the same arm of the breast they’re nursing on
- You may support your breast with the opposite hand while allowing baby to latch
- Then lean back and relax!
This upright position may help with baby gas, reflux, fast flow, or overactive let-down.
Questions or Comments on “The Best Breastfeeding Positions for Babies with Reflux”
If you have any questions or comments, please leave them below👇🏻
Talk soon, mama!
– Katelyn Lauren
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References:
[1] Milinco, M., Travan, L., Cattaneo, A., Knowles, A., Sola, M. V., Causin, E., Cortivo, C., Degrassi, M., Di Tommaso, F., Verardi, G., Dipietro, L., Piazza, M., Scolz, S., Rossetto, M., Ronfani, L., & Trieste BN (Biological Nurturing) Investigators (2020). Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial. International breastfeeding journal, 15(1), 21. https://doi.org/10.1186/s13006-020-00261-4
DISCLAIMER: This post is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding you or your baby’s health. Please read my Medical Disclaimer for more info
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