Newborn itch, or gastroesophageal reflux (GER) is when a baby regurgitates or spits up milk. This is common and something many parents have to deal with. Aside from being messy, it’s usually harmless. If your baby has complications such as excessive irritability, trouble eating, or trouble gaining weight, it may be gastroesophageal reflux pain (GERD).
Key takeaways
- Reflux (spitting up) in newborns and infants is common and not usually painful or problematic.
- Babies who seem sick, have feeding problems, or have other complications with reflux may have GERD. Talk to your baby’s doctor if you think they have GERD.
- Reflux and GERD in babies can usually be treated at home by keeping them upright after feedings, giving them smaller and more frequent feedings, lying down well, and keeping them from exposure to secondhand smoke.
- Acid-reducing medication is not usually recommended but may be prescribed if other methods do not help.
- Reflux in infants improves with age and usually disappears within 9-12 months.
What is acid reflux in newborns and infants?
Newborn reflux, or gastroesophageal reflux (GER), is common. This is when the contents of the stomach go up into the esophagus. It often occurs in newborns for several reasons.
For one, the ring of muscles between the stomach and the esophagus — called the lower esophageal sphincter (LES) — is immature in babies and often opens when it shouldn’t, allowing stomach contents to move through. upwards.
In addition to this, a baby’s diet consists only of liquid milk, which moves easily. Young babies also spend a lot of time lying down, so gravity doesn’t stop them from eating.
Spitting up, while messy, is usually not painful for babies and is not the only cause for concern. GER is not something that needs to be treated.
However, if spitting up is accompanied by complications affecting your baby, they may develop gastroesophageal reflux pain (GERD), which may require treatment.
Newborn reflux symptoms
How does a baby with reflux behave? Symptoms of infant reflux include spitting up or regurgitating milk after feeding. If the baby has reflux alone, but it’s not GERD, they seem mostly content even if they spit up. If they have GERD, they will likely have other symptoms along with spitting up.
Signs of GERD in infants include:
- Frequent and severe spitting
- Violent or projectile vomiting
- Crying when spitting
- Blood or green color in the sputum
- Arching of back and movement of neck as if painful, especially after eating
- Irritation, particularly after eating
- Picky eaters or refuse to eat
- Stomach is hard or swollen
- Gagging or choking on spitting
- Coughing, wheezing, or breathing problems
- Poor weight gain
- Less wet and dirty diapers
If your baby shows any of these signs, talk to their pediatrician about whether it could be GERD. There are things other than GERD that can cause some of these symptoms in babies.
Your baby’s doctor may want to rule out other problems. They will ask about your baby’s symptoms and eating habits and check their growth. They may want to perform some tests to confirm that they have GERD.
Natural remedies for acid reflux in babies
Some ways you can help your baby’s reflux naturally at home are:
- Feed them in an upright position.
- Keep them upright for about 20-30 minutes after eating.
- They burp when they take a natural break from eating. They burp good and often.
- Make sure your baby has a proper latch on the breast or bottle to prevent swallowing too much air, which can cause spit-up and gas pains. A lactation consultant can help you with this if you are unsure.
- Give your baby smaller and more frequent feedings to avoid overfilling their stomach.
- Do not smoke around your baby and prevent their exposure to any secondhand smoke.
Your baby’s doctor may suggest that you try softening your baby’s feeds with baby cereal. Do this only under your doctor’s recommendation. It may also be suggested that you try eliminating dairy from your diet if your baby is breastfed or try a different formula if formula fed. (Here’s a post on how to transition between formulas without rocking the boat too much.)
Baby reflux medicine
Medication is not usually recommended for infants with uncomplicated reflux. While the drug reduces the amount of acid produced in their stomach, it does not prevent reflux or spitting up. Medication won’t help a “happy spitter” and probably won’t help a baby who is mildly or moderately upset when they spit up.
However, your baby’s doctor may recommend a trial of medication if they are very irritable, have an inflamed esophagus, are not eating well, or are losing weight — especially if other home treatments haven’t worked.
The medicine your baby may be prescribed is an H2 blocker such as famotidine (Pepcid) or a PPI (proton pump inhibitor) — such as omeprazole (Prilosec) or lansoprazole (Prevacid). These medications reduce stomach acid so reflux is less painful.
If their medicine doesn’t work after a few weeks, the doctor will probably have you stop giving it. Babies usually only take the medicine for a few months before it goes away because reflux symptoms usually improve with age.
What can trigger reflux in babies?
Reflux can be made worse by a baby eating too much food in one sitting and overfilling their stomach. Lying down immediately after eating or having pressure on their stomach after eating can also cause spitting up.
Swallowing a lot of air can cause gas pains and spitting up. This can cause the baby to be fussy along with spitting up. Burping occasionally during and immediately after feedings can help relieve wind and reduce gas and spit up.
A bad feeding latch can cause your baby to swallow air while feeding, which can lead to fussiness and baby reflux symptoms. Making sure your baby is latching on properly to the breast or bottle can help. If you’re unsure about your baby’s latch, consult their doctor or a lactation consultant.
If your baby continues to have difficulty latching and seems to be swallowing a lot of air, it may be a good idea to also consult a pediatric dentist to check for tongue or lip tie. Tongue ties and lip ties can prevent a good latch and lead to the baby swallowing air while eating. (Wondering if your baby has lip or tongue tie? Here’s some information on what to look for.)
Does a pacifier help with reflux?
this is can that sucking on a pacifier can cause the baby to swallow air, which can cause gas and therefore worsen reflux symptoms. The same is true for a bottle nipple that is too small.
However, babies also swallow air while crying, especially if they scream or cry loudly. If a pacifier can calm a fussy baby, it can also prevent them from swallowing air during intense crying.
A pacifier is also a better method of comfort than the breast for a baby with reflux. If your baby is hungry, make sure to feed them. But if your baby seems to just want to suck for comfort, a pacifier is a better choice to avoid overfilling their stomach and causing discomfort and reflux.
Does warm or cold milk help with acid reflux in babies?
For reflux, the temperature of the milk is not important, and there is nothing wrong with giving a baby cold milk if they want it. Always make sure when preparing a bottle that the milk is not too hot. Always check the temperature of the bottle by swirling it to mix the milk, then test a little on your wrist.
How should a baby with reflux sleep?
It is always important to lay your baby down to sleep on his back, on a flat, hard surface, with no blankets or pillows around him. (Jump to the reflux section in the safe sleep post from an infant safe sleep expert.)
Can gripe water help with reflux?
Some parents use over-the-counter gripe water to treat their baby’s reflux, although there is no evidence that it helps. Gripe water usually has fennel and ginger, both of which are thought to aid digestion.
Should I breastfeed if my baby has reflux?
Yes, you should breastfeed your baby if you choose, even if they have reflux. There is no need to stop breastfeeding a baby with reflux or GERD
Foods to eat or avoid when breastfeeding a baby with acid reflux
Unless the doctor suspects a cow’s milk allergy, it is usually not necessary for a nursing mother to change her diet. In that case, the doctor may have you eliminate dairy to see if it improves symptoms.
It is true, however, that certain foods can change the taste of breast milk and can contribute to irritability and restlessness. If you suspect a particular food is making your baby’s reflux or fussiness worse, you can try eliminating it from your diet for a week or so to see if it helps.
How long does infant reflux last?
Infant reflux usually occurs around 2 or 3 weeks of age as a newborn. Reflux usually increases in babies around 4 months.
The good news is that after 6 months—when babies tend to have a more developed digestive system and are able to sit up, as well as having solid foods introduced into their diet—their symptoms often begin to improve. and resolves by age 9 to 12 months. .
Again, if you suspect your baby has GERD, or you have other concerns related to their reflux, talk to their doctor. You can usually treat reflux and GERD with natural methods at home, but a doctor can facilitate medical treatment if necessary.
Take heart in knowing that spitting up is normal, doesn’t usually negatively affect your baby, and will improve as they grow.
Have you ever experienced reflux in your baby?
Let us know what worked for you in the comments below.
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