All you need to know about Reflux

What is infant reflux?

Infant reflux occurs when food backs up (refluxes) from a baby’s stomach, causing the baby to spit up. Sometimes called gastroesophageal reflux (GER), the condition is rarely serious and becomes less common as a baby gets older. It’s unusual for infant reflux to continue after age 18 months. Reflux occurs in healthy infants multiple times a day. As long as your baby is healthy, content and growing well, reflux is not a cause for concern. Rarely, infant reflux can be a sign of a medical problem, such as an allergy, a blockage in the digestive system or gastroesophageal reflux disease (GERD).

What are the symptoms?

Infants’ reflux generally does not cause symptoms that are concerning.  Most infants with reflux are called “happy spitters.” These are infants who spit up but remain comfortable when it happens.  They continue to gain weight normally and outgrow it in a few months.

You should seek medical attention if any of these symptoms are present:

  • When your baby isn’t gaining weight
  • Consistently spits up forcefully, causing stomach contents to shoot out of his or her mouth (projectile vomiting)
  • Spits up green or yellow fluid
  • Abnormal arching
  • Refuses food
  • Disturbed sleep
  • Has difficulty breathing or a chronic cough
  • Is unusually irritable after eating

Some of these signs can indicate possibly serious but treatable condition of GERD (gastroesophageal reflux disease)

What age can reflux start? Is it more common in babies of a certain age?

Reflux can start from newborn period.  It is most common around four months (61 percent), decreasing to 21 percent between six and seven months. In almost all children with reflux, the condition improves and usually resolves by the end of the first year of life

Is reflux as likely in breastfed babies as it is in bottle fed babies?

Breastfeeding may have a protective effect on regurgitation in infants, based on limited data.   Breastfed neonates experience less nocturnal esophageal acid exposure compared with formula-fed neonates.  The protective effect of breastfeeding might include differences in gastric emptying between breastfed and formula fed babies or differential exposure of infants with a cow’s milk protein intolerance, but these possibilities have not been formally evaluated.

What should a parent do?

Parents can try these strategies to help your babies with reflux.

  • Giving your baby smaller, more-frequent feedings.
  • Interrupting feedings to burp your baby.
  • Holding your baby upright for 20 to 30 minutes after feedings.
  • If you are breastfeeding, you can do trial of eliminating dairy products, beef or eggs from your diet if you’re breast-feeding, to test if your baby has an allergy.
  • In formula fed baby, you can try switching to extensively hydrolysed formula or hypoallergenic formula.
  • If your baby is bottle fed, you can try using a different size of nipple on baby bottles. A nipple that is too large or too small can cause your baby to swallow air.

However, if these measures do not seem to help, it is time to see your baby’s doctor.

Dr Bernadeta Wibisono is a paediatric doctor based at IMC Children’s, 14th F Camden Medical Centre.
Call 6887 4440 to make an appointment

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