What goes down must come up can seem to be the rule when feeding an infant. While small amounts of spit-up are normal, continual spitting up or vomiting after feedings may signal a condition known as gastroesophageal reflux disease, or GERD.
Basics
Gastroesophageal reflux occurs when stomach acid enters the esophagus. The lower esophageal sphincter is a muscle that connects the esophagus and the stomach. It opens to allow food to enter the stomach for digestion, but sometimes it opens again, allowing digestive juices to enter the esophagus. This leads to the burning feeling and chest pain often described as heartburn. While occasional reflux is common, persistent reflux occurring after almost every meal can be a sign of GERD.
GERD in Infants
According to the National Digestive Diseases Information Clearinghouse, while more than half of all babies have reflux during the first three months of life, in most cases it resolves itself by the time child is between 12 and 24 months. However, chronic reflux in an infant can be a sign of GERD. In infants the symptoms of GERD include frequent spitting up and vomiting, pain and constant, sudden crying and refusing food. Untreated GERD can lead to breathing problems and poor growth. A doctor is needed to test for GERD.
Feeding Tips
An infant with a mild case of GERD may only require slight adjustments to his feeding routine. Thickening formula or expressed breast milk with cereal can be helpful, as well as adjusting the feeding schedule so that a smaller amount is offered at more frequent times. A breastfeeding mother may need to look at her diet to see if certain foods may be triggering the reflux in her infant. Common food culprits include spicy foods, tomato-based foods, citrus foods and high fat foods.
Feeding Positions
Holding an infant upright after feeding can be helpful in reducing reflux, as well as limiting the time that the infant is seated in a car seat when not riding in a car. If the infant spits up during or immediately after eating, wait until the next scheduled feeding before offering more. This allows the infant's digestive tract a period of rest.
Consult a Doctor
It is important to talk with a pediatrician before making any changes to the infant's diet. A doctor may recommend special infant formulas with added rice cereal or other nutrition interventions to meet the needs of the infant. Some brands of rice cereal can contain milk and soy proteins, so caution will be needed for infants with allergies or sensitivities to these proteins. There are many tactics and treatments for managing GERD, and teaming up with a health-care professional is the best approach.
References
- National Digestive Diseases Information Clearinghouse: Gastroesophageal Reflux in Infants
- Nemours Foundation: Gastroesopheageal Reflux
- Children's Digestive Health and Nutrition Foundation: Parent's Checklist for Reflux in Infants 0-12 months old
- National Digestive Diseases Information Clearinghouse: Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)
