Infant Refllux

All babies spit-up now and then, but for some babies it happens with almost every time they eat. This condition is called infant gastroesophageal reflux. The baby’s stomach is unable to hold in what he just ate so it rises up the esophagus. This can lead to a large vomit or spit-up of uncurdled milk or it can cause “wet sounds” in the chest and crying after the feed. Some babies are uncomfortable with the reflux and some will have no reaction as they vomit all over your sweater! The symptoms should always be discussed in depth with your pediatrician. This will help the doctor decide if it is reflux requiring treatment or a different condition related to a milk allergy, infection or anatomical problem.

Treatment for spitting-up doesn’t depend on how much milk comes flying out of your baby’s mouth but rather other symptoms. If your infant isn’t gaining weight well, excessively crying and fussy after eating, or choking and coughing, then your doctor will likely recommend some form of treatment. Treatment can involve medication but it can also be simple changes in feeding. Smaller and more frequent feeds can help. You may need to keep the baby upright in your arms or in a bouncy seat for 30 minutes after she eats. Proper burping is crucial. Some doctors may recommend thickening the liquid in the bottle with infant rice cereal. If you are breastfeeding this may not be possible or you may have to pump your milk into a bottle. This is not a popular solution for many mothers.

Testing can be very elaborate and not always necessary. If the reflux is mild and resolves easily with the first treatment you and your pediatrician try, then your doctor will often avoid invasive testing for reflux. Sometimes the extent of the problem or questions about the diagnosis requires many levels of testing. A pediatric gastroenterologist can also do further testing and may be recommended by your regular doctor.