More than half of all babies experience reflux during their first three months of life. Infant acid reflux occurs when contents of the stomach back up into the esophagus. Symptoms of reflux may include spitting, vomiting, coughing, irritability, poor feeding and blood in the stool. Infant reflux typically will resolve on its own when a baby is around 12 to 18 months old. Infant reflux can lead to poor growth or breathing problems but this is rare.
Immature Lower Esophageal Sphincter
The ring or muscle between the esophagus and the stomach or the lower esophageal sphincter, or LES, relaxes and opens to allow swallowing. The LES also opens to release gas following meals; otherwise, the LES is tightly closed. Until this muscle is mature, stomach contents, including acid, sometimes can flow up the esophagus and out through the mouth resulting in regurgitation, spitting up, or vomiting.
Straining
Reflux in infants can also occur with strain such as with coughing or crying. This can occur due to pressure in the stomach increasing at these times. Anything that causes the LES to relax or increases pressure below the LES can cause reflux. Reflux symptoms include crying when the baby is placed on its back, especially after feeding, frequent or persistent cough or colicky behavior. It is recommended to burp a baby after consuming one to two ounces of formula or for breast-fed infants to burp after feeding on each side to help avoid symptoms of reflux.
Feeding Too Fast
Reflux can also occurs simply because the infant drinks too much, too fast. In other cases, air bubbles in the esophagus may be pushing liquids out of the infant's mouth. Overfeeding can also aggravate reflux so it may be necessary to provide smaller, more frequent feedings to help decrease the chances of regurgitation. It is also recommended, when possible, to hold the infant upright for at least 30 minutes following feedings to help avoid reflux.
