What goes in, sometimes comes right back out again! Most babies have some degree of reflux; here's why, and what you can do to help.
When it comes to babies, most parents soon find that what goes in... sometimes comes straight back out again. The real mystery lies in figuring out what sort of up-chuck you're dealing with.
Regurgitation or posseting is very common and happens on a daily basis for about 50% of babies. This is the classic baby spit-up: usually shortly after a feed (and if you're really unlucky, right down the back of your clean t-shirt).
Doctors sometimes refer to this as gastro-esophageal reflux (GOR), and it happens because the muscular ring at the bottom of your baby's food pipe (esophagus) is not yet fully developed. This allows the contents of the stomach to flow back into the food pipe when the stomach is full – which sometimes means a bit of a mess for Mum and Dad. However, it's not usually a big problem for babies, and most will grow out of it by the time they turn 1.
In the meantime, there are a few things you can do to help soothe your baby's reflux:
- Try offering smaller, more frequent feeds so that your baby’s tummy is not as full.
- Keep your baby in an upright position for about 20 minutes following a feed.
- Raise the head of the mattress slightly in your baby’s cot (putting a book under the mattress is one way to do this).
- Wind your baby frequently, both between and after feeds.
- Try loosening the tabs on your baby’s nappy a bit, so that they put less pressure on a tummy that's full of milk.
However, if your baby is having trouble gaining weight, seems irritable and unhappy after a feed, coughs and wheezes a lot, or is struggling with feeding, it's worth speaking to your GP or paediatrician. It may mean your baby has gastro-esophageal reflux disease (GORD), a more severe form of reflux, and in this case your GP may recommend treating the problem with medication. Some of the available treatments include:
- Medications that thicken the stomach contents, making it harder for milk to come back up the esophagus (i.e. Infant Gaviscon)
- Medicines that reduce the acidity of the stomach contents (i.e. ranitidine and omeprazole) and those that help the stomach empty more quickly (i.e. domperidone)
- Specialised formula milks – known as pre-thickened or anti-regurgitation (AR) feeds
- If your doctor thinks your baby's GORD may be associated with Cow’s Milk Protein Allergy, you might be prescribed a hydrolysed formula milk (where the protein in the milk has been broken down). If you are breastfeeding, your doctor might ask you to try excluding cow’s milk from your diet for a while (and take a calcium supplement).
- In very severe cases of GORD where medical treatment is ineffective, your doctor might recommend anti-reflux surgery, but this is rare.
If your baby has reflux, it's worth paying special attention when it comes time for weaning (it won't be long, trust us!). Some babies with reflux have a harder time moving on from pureed foods to lumpier textures and finger foods. If this does happen, it's worth getting advice from your GP or health visitor to help your baby adapt to eating foods with more texture.