If you have a spitty baby, you have a lot of company. Over 50 percent of babies have some degree of reflux in their first 3 months, MedlinePlus reports. Reflux simply means that stomach contents back up from the stomach through the esophagus, out the baby's mouth and often right into your lap. While gastrointestinal reflux usually resolves without complication within 18 months, some babies have a more serious condition called gastroesophageal reflux disease, or GERD. Worsening reflux can indicate your baby has GERD and may need treatment.
Normal Reflux
Nearly all babies spit up from time to time. Overfeeding or air bubbles that bring up a small amount of milk when you burp the baby can cause reflux, but an immature lower esophageal sphincter muscle causes most cases. The muscle between the stomach and esophagus opens to allow food through and then tightens to keep it where it belongs. As your baby grows, the angles of the stomach and esophagus change and reflux occurs less frequently. You may not know your baby has reflux in many cases, since the formula stays in the esophagus. Colic and GER may have similar symptoms. Between 15 to 40 percent of babies with GERD may have dietary protein-induced gastroenteropathy caused by milk or soy allergy, according to Harvard pediatrician Harland Winter, M.D.
Worsening Symptoms
Symptoms that indicate reflux has become a more serious problem include poor weight gain, poor feeding, irritability, forceful vomiting, coughing, wheezing or choking. Your baby may act like she's in pain, arching her back and crying. She may lose blood in the stool and in vomitus from acid burning the esophagus. Aspiration pneumonia can occur. The esophagus may become scarred and narrowed over time.
Simple Measures
If your baby has worsening GER, simple measures may help improve it. Placing blocks under the head of the crib to raise it can put gravity to use in keeping formula where it belongs. Holding the baby upright or placing him in an infant seat for 20 to 30 minutes after a feeding can accomplish the same thing. Burping more frequently or adding cereal to the formula to thicken it if your doctor agrees are other options. Taking care not to overfeed by pushing the baby to take the last little bit in the bottle may also help. Cutting dairy products and soy from your diet may help if you're breastfeeding.
Medications
Medications can help with GERD, although most infants outgrow the condition by age 1 to 2 without medications, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Medications that block acid production in the stomach can stop the esophageal and stomach burning that lead to pain, erosion and weight loss from an inability to eat. Both proton pump inhibitors and histamine receptor antagonists, called H-2 blockers, decrease acid production, but in different ways. Proton pump inhibitors have a greater effect on decreasing stomach acid than H-2 blockers. Side effects of H-2 blockers include diarrhea, constipation and abdominal pain. Liver problems can occur with long-term use of both PPIs and H-2 blockers, so give them to your baby only under your doctor's supervision.
References
- MedinePlus; Gastroesophageal Reflux in Infants; August 2009
- "Pediatric Views"; Treating Acid Reflux in Infants; Samuel Nurko, M.D.
- UpToDate; Acid reflux (Gastroesophageal Reflux) in Infants; Harland Winter, M.D.; May 2008
- Barrett's Esophagus; Medical Treatment of GERD; January 2008
- National Institute of Diabetes and Digestive and Kidney Diseases; Gastroesophageal Reflux; August 2006
