Did you know that it’s normal for babies under 3 months old to spit up three times a day? But often, in this case, many parents begin to worry about newborn reflux. Let’s check out newborn reflux signs, newborn gastroesophageal reflux, and “does my newborn have reflux?!”
What’s worse is that too often, doctors give the baby reflux medications after only giving the baby a little more time to see if the spit-up slows down [1].
Let’s talk about some effective methods for dealing with spit-up and reflux. Plus, why we should definitely 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 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 a Baby with Reflux
If your baby is spitting up 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.
Questions or Comments on “Newborn Reflux: What You Need to Know to Help”
If you have any questions or comments, please leave them below👇🏻
Talk soon, mama!
– Katelyn Lauren
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Sources:
[1] Safe M, Chan WH, Leach ST, Sutton L, Lui K, Krishnan U. Widespread use of gastric acid inhibitors in infants: Are they needed? Are they safe?. World J Gastrointest Pharmacol Ther. 2016;7(4):531-539. doi:10.4292/wjgpt.v7.i4.531
[2] Carroll AE, Garrison MM, Christakis DA. A systematic review of nonpharmacological and nonsurgical therapies for gastroesophageal reflux in infants. 2002. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK69506/
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