A newborn baby spitting up after a feed is considered normal by many parents. Well, babies burp like adults, and when they do, they may or may not spit up milk.
But, what to do when this act of spitting up milk increases multifold, and your baby constantly vomits everything she drank, losing weight and is very irritable after eating?
Gastroesophageal reflux (GER) is a reflux where the baby spits up milk after a feed while burping. This is a common occurrence in babies as well as adults. GER is common in infants under 2 years and for babies less than 3 months to spit up milk a few times a day. Symptoms of acid reflux in newborn first shows up around 2 to 4 weeks and peaks around 4 months, which resolves when they are 12 to 18 months of age. Gastroesophageal reflux disease (GERD) is a long term digestive disorder and a long-lasting form of GER. The symptoms of GERD, when it occurs after 12 to 14 months, include spitting up, vomiting, reduced feeding, breathing issues, fussiness and crankiness, frequent hiccups, and losing weight. The natural remedies for calming acid reflux in babies are burping them, frequent but small feedings, not over-feeding them, keeping baby in an upright position after feeding, avoiding tight diapers and clothes, and checking the nipple size of the bottle to avoid the baby swallowing too much air.
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What is GER and GERD in babies?
When a baby eats, the food goes from her mouth to the stomach through the esophagus. At the end of the esophagus is a muscle that joins the esophagus to the stomach, called the lower esophageal sphincter (LES).
LES is a muscle that remains shut after the food enters the stomach, but occasionally LES relaxes which lets the food or stomach juices back up the wrong way and the baby spits up milk.
This reflux is called Gastroesophageal reflux (GER) or also known as acid reflux. But, extreme acid reflux may also point to another problem such as GERD.
When does GER become GERD
- Your baby has GER for more than 14 months of age.
- Your baby has trouble feeding because of breathing problems, coughing, vomiting, and gagging.
- Your child has GER more than twice a week for a few months.
What causes acid reflux in babies?
The LES in babies are still developing, and since the digestive system doesn’t function like that of an adult, the food contents in the stomach may back up the esophagus, leading to vomiting or spitting up. Everyone has reflux from time to time, babies and adults. The acidic taste you get in your mouth after you burp is an acid reflux.
Babies who occasionally spits up after a feed are also known as ‘happy spitters’. Babies have a weak LES, and that’s why the LES relaxes at the wrong time when it should’ve stayed shut, and the content of the stomach goes all the way back up causing them to vomit. Other reasons why babies suffer from acid reflux is they are lying flat all the time, they are only on a liquid diet, and if they are born prematurely.
I remember as a new mom, I would get scared when my little one would spit up after each feed when he was 6 weeks old and when checked with the pediatrician I was told that it was perfectly normal for babies to do until it doesn’t start affecting their weight.
Symptoms of acid reflux in babies
Acid reflux in babies show up when they are between 2 to 4 weeks; it peaks around when they are 4 months old and starts to subside when they’re 7 months old when they start sitting upright and take in more solids.
GERD symptoms are:
- Frequent and sometimes forceful vomiting or gagging more than 5 times a day and more than an ounce each time
- Uneasiness after feeding
- Refusing to eat
- Inconsolable cry mainly due to pain
- Arching of the back during feeding
- Wet burps or hiccups due to excess air in the tummy
- Unusual fussiness
- Coughing or wheezing sound during feeding
- Difficulty sleeping
- Slow weight gain
Sometimes acid reflux cause irritation in the esophagus, also known as heartburn in babies, which can make them arch their back abnormally while feeding and may unlatch multiple times from the nipple during breastfeeding.
Your baby may cough frequently, or you can hear a wheezing sound when they’re feeding; this is because of the stomach acids getting up in the upper airways. This symptom can worsen if your baby is lying on his back.
How long will a baby have acid reflux?
Acid reflux in babies usually subsides down when they are 7 months old. In some cases, baby’s acid reflux can last until they are 1 or 2 years old. It is rare for a baby to experience GER after they’re 18 months old, and if the symptoms persist; your baby might have GERD.
Make sure to talk to your child’s doctor if you suspect of your baby having GERD.
Natural remedies for Acid reflux in babies
If your baby is showing signs of acid reflux, then you can follow these steps:
Breastfeed your baby
If possible, breastfeed your baby or pump and bottle feed your breast milk. Breast milk is known to be more easily and quickly digested by newborns compared to formula.
Feeding less but frequently
Instead of feeding them for a long time, feed small amounts of breast milk or formula frequently.
This will help the baby’s stomach to have time to digest the food properly, reducing acid reflux.
Burp your baby often
You should never fail to miss this step. I always make sure to burp my baby before, in-between and after a feed to avoid any gas build-up.
Hold your baby in an upright position after feeding
Try to prop your baby in an upright position for 20 to 30 minutes after feeding to help alleviate the symptoms of GERD.
You can also offer a pacifier after the feed as sucking helps reduce the acid reflux.
Change your baby’s formula or bottle
If your baby is on formula and experiencing acid reflux symptoms, consult your doctor about changing your baby’s formula and about using a slow-flow nipple.
Delay playtime after feeding
Avoid playing with or bouncing your baby after she is fed. Playing with your baby after a feed can alleviate acid reflux in babies.
Avoid making your baby wear tight clothes or diapers
Tight clothing around baby’s tummy can apply pressure and can make her irritable and in pain.
Change your diet
You can try changing your diet; avoid foods such as dairy products, or gas-inducing vegetables like cabbage, broccoli, and cauliflower if you’re breastfeeding.
Medical treatment for Acid reflux
Mostly acid refluxes are often resolved by these natural remedies. But, if these remedies don’t seem to work, it’s best to talk to the pediatrician for prescription medicine that is safe to give your newborn to relieve them from the symptoms.
Although babies tend to overcome these symptoms by their first birthday, if it still persists, don’t worry about the medications prescribed; most common medicines are very safe and effective.
An acid-blocking medication like cimetidine (Tagamet HB) or famotidine (Pepcid AC) are usually recommended by doctors for babies from 1 month to 1 year of age if they suffer from an inflamed esophagus, the baby has chronic asthma and reflux, or refuses to feed which also causes poor weight gain in the baby.
When should I consult the doctor?
Before you visit your doctor, make sure to write down the symptoms you suspect your baby has, and the questions that you want to ask your baby’s doctor. Your doctor might ask you for how long and how often you feed your baby, and which formula brand you’re currently using, so make sure to note down that too.
You should immediately call or see your baby’s doctor if the following occurs:
- Your baby vomits more than half the feeding
- If she spits up green or yellow fluid
- If there are streaks of blood in the vomit or the stool
- If your baby seems to be in pain
- Slow or no weight gain
- If your baby hasn’t passed urine for more than 6 hours
- If your baby develops fever higher than 100°F.
- Decreased responsiveness
- If your baby is constantly crying for more than 2 hours and cannot be consoled
- Your baby suffers from pneumonia
- Your baby seems to be dehydrated
- Refusing to feed for a prolonged time
The bottom line is acid reflux in newborns and infants are a treatable condition. They usually go away as your baby ages. Make the necessary changes in your lifestyle and try out the natural remedies to relieve your baby from acid reflux symptoms.
Usually, these adjustments at home will help your baby, but if you think that something’s wrong and the symptoms have become severe, then it’s necessary that you receive a proper diagnosis. So, calm down and give your pediatrician a call to clear off any doubts.