As a new mother or father, you are probably adjusting to having spit up on you when your baby burps. You may not realize that large amounts of spit up can actually indicate a condition known as acid reflux. Typically, acid reflux is associated with adults; however, approximately 50 percent of babies under three months old develop acid reflux. The condition usually goes away by the time they are twelve to eighteen months old, but in the mean time, it can be quite the headache.
What is Acid Reflux?
Normally, the ring of muscles between the esophagus and the stomach are constricted; they only open when you swallow. However, if there is a condition present that causes the muscle to be relaxed and open, the contents of the stomach (such as your baby’s milk and stomach acids) can spill out. Once these spill out, they flow back up the esophagus and out of the mouth in the form of excessive spit up or vomit.
The most common reason for acid reflux in babies is an immature digestive system. Other causes include eating too much, too fast or getting air bubbles in the esophagus that cause the liquid to be pushed up and out of the throat.
Symptoms of Acid Reflux in Babies
Before you can begin to treat acid reflux in babies, you need to know the symptoms so that you can make sure it is acid reflux. Symptoms can include:
- Excessive spitting up
- Fussiness after feeding
- Crying when placed on back
These are common symptoms. If your child has more severe symptoms, such as spitting up blood or bile, fever, projectile spit up, diarrhea, or is not gaining weight, call your pediatrician immediately. You do not have time to try home treatments.
Treating Acid Reflux at Home
If your baby’s acid reflux has not affected weigh gain and they are not in obvious distress, you can try treating it at home with these simple, non-medication techniques.
- Breastfeed: Breast milk is nature’s milk for your baby and, if at all possible, should be what your baby is eating. Your baby’s body will digest it faster, which prevents the possibility of spitting it up. If you are not able to breastfeed (and some women are not), you can consider buying breast milk from a surrogate.
- Change Your Diet: If you are breastfeeding and your baby has acid reflux, you may need to change your diet. Spicy foods, caffeine, and alcohol can all cause your baby to have acid reflux. Always remember that whatever you eat while you are nursing is also going into your baby.
- Feedings: Feed your baby smaller amounts more frequently. If the stomach is too full, it can exert pressure on the esophagus. This pressure can cause reflux, which results in spit up. Remember that if you do this, your baby will not feel full and may want to eat more often.
- Do Not Overfeed: You should avoid giving your baby a bottle to soothe fussiness. Overfeeding causes the stomach to overflow and can result in excessive spit up.
- Position: Feed your baby in an upright position with a straight spine: This position forces the milk further down and into the intestines. Babies who feed while lying down or who are held with their neck turned will also swallow more air. This air will cause reflux.
- Burp More Often: You already know you need to burp your baby after feeding. However, if your baby is experiencing acid reflux, you need to burp more often during feeding. Do not lay the baby across your legs to burp, as this will place pressure on the stomach and cause the milk to come back up the esophagus. Hold the baby over your shoulder as straight as possible and gently pat their back until you hear the burp.
- Rice Cereal: Thicken the formula or breast milk with rice cereal. Pediatricians and many parents have reported that the thicker volume does not come back up the esophagus as easily as thin milk.
- Change Bottles: Limiting the amount of air your baby ingests provides relief from acid reflux. You may have to experiment with various bottles and nipples to find one that does not allow your baby to ingest large volumes of air. There are bottles on the market designed specifically for babies with acid reflux. These may provide relief.
- Check the Nipple: If your baby bottle is not the problem, the nipple might be too large. If the hole in the nipple is too large, the baby will drink too fast or ingest too much air, causing them to spit up their milk.
- Keep Your Baby Upright and Calm: You should not put your baby down for a nap immediately after feeding. Keep your baby in an upright position for at least half an hour. This allows gravity to keep the milk down longer and helps them digest it. You should also avoid over-stimulating your baby after feeding. Over-stimulation can cause the regurgitation associated with acid reflux.
- Avoid Tight Diapers and Clothing: Anything that binds the baby’s tummy can cause discomfort and push the stomach contents back up the esophagus.
If none of these home options work or your baby is worse instead of better, you should see your pediatrician. There are medications and procedures that can eliminate or reduce acid reflux and make your baby a happy, healthy baby. Some of the treatments include:
- Medication: Your doctor can prescribe medications such as H-2 blockers and proton-pump inhibitors. Although these are typically used in adults, there are infant-sized dosages that your doctor can use to help your baby. Your doctor will discuss these with you and the possible side effects associated with infants, such as increased respiratory infections.
- Surgery: Your pediatrician will discuss with you the possibility of using surgery to relieve the acid reflux. This surgery involves tightening the muscles that allow food into the stomach so that it does not allow food back out of the stomach. However, due to possible complications from the surgery, this is only recommended if your baby is not growing or has problems breathing due to reflux.
Acid reflux is an uncomfortable condition for anyone, particularly babies who have no way to tell you how they feel. When you see your baby spitting up more than normal or in voluminous amounts, ask your pediatrician if you can try the home remedies mentioned. If these do not work, seek the help of your pediatrician and remember most babies will outgrow the condition as their digestive system matures.
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