Understanding Infant Reflux

Spitting up is common for babies but if it happens too often, it might be infant reflux. A Henry Ford Health pediatrician explains what infant reflux is and how to help your baby.

New parents know: spit up happens. More than half of all babies will experience some form of infant reflux, such as spitting up after eating or even excessive burping.

“As long as your baby is happy, healthy and growing appropriately, reflux is rarely problematic,” writes Henry Ford Health pediatrician Stacey Leatherwood Cannon in a blog post. “Babies with gastroesophageal reflux disease or GERD, on the other hand, spit up frequently. They’re fussy, irritable and may arch their backs in pain.”

No parent wants to watch their baby suffer this way. And of course, you may worry that the excessive spitting up will affect your baby’s nutritional intake and growth. It helps to understand what infant reflux is and as a parent, what you can do about it.

What exactly is infant reflux and why does it happen?

Infant reflux occurs when the contents of a baby’s stomach flow back into the esophagus. This common phenomenon is often caused by an underdeveloped lower esophageal sphincter (LES), allowing stomach contents to travel back up toward the esophagus. 

“In newborns, that sphincter is like a loose rubber band, especially among babies born prematurely. Children who have development issues or who are born with a naturally loose esophageal sphincter are more vulnerable to reflux,” Dr. Leatherwood Cannon notes.

Luckily, most babies outgrow reflux by 18 months of age. However, for a child with severe infant reflux or GERD, the symptoms can include respiratory difficulties like coughing, choking or even breathing in their own gastric contents. 

For children with severe reflux, the condition can persist. “Symptoms and side effects can last well past a child’s second birthday,” says Dr. Leatherwood Cannon. 

When to call a health professional

A little spit up is normal, but parents should be aware of signs that indicate a more serious problem. “While symptoms of GERD vary, you should schedule an appointment with your child’s pediatrician if you notice any of the following in your baby,” cautions Dr. Leatherwood Cannon.

Henry Ford

Your pediatrician will refer you for testing if necessary. Parents should know that timely diagnosis of infant reflux allows for effective management and prevents potential complications.

Is there a way to manage infant reflux?

Now for the good news: “Reflux tends to peak around four to six months of age and then improve,” says Dr. Leatherwood Cannon. “Older babies start eating solid foods and consume less liquid – and solids are easier to keep down. But reflux isn’t something babies just have to live with as they grow older.”

So what can parents and caregivers do to help a baby who is struggling with reflux? 

Dr. Leatherwood Cannon recommends frequent burping as one strategy. “Instead of waiting until your child reaches the end of a bottle, try burping after each ounce of milk or formula,” she says. 

If you’re breastfeeding, try shorter, more frequent feedings to help reduce overfeeding and gas for your baby.

Dr. Leatherwood Cannon’s other tips for reducing infant reflux include:

  • Place your baby upright while feeding. “Never feed a baby while she is lying down,” says Dr. Leatherwood Cannon. “Instead, make sure that she is at a 45-degree angle, which helps ensure milk flows down the esophagus and into her tummy.”
  • Don’t overfeed your baby. When it’s time for an increase of food, start giving it to your child gradually, a half an ounce a time.
  • Thicken the breastmilk or formula. Your doctor may recommend using rice cereal to thicken the liquid, which can help keep your baby’s food down. Include one teaspoon of cereal for every ounce or two of milk. Some formula brands already contain rice cereal. Besides not requiring mixing, they are usually smoother, too, says Dr. Leatherwood Cannon.
  • Keep your baby sitting upright after eating. Wait at least 30 minutes after feeding before laying your baby down. This aids with digestion.

What about spitting up while sleeping?

If your baby has reflux, you may be afraid they will choke if they spit up while asleep. Dr. Leatherwood Cannon emphasizes that you should put your baby on their back and not prop them up with anything like pillows or other soft objects during naptime or bedtime. 

“Babies with reflux will naturally turn their heads to one side to spit up,” she explains. 

Parents should be aware that placing items in the crib or putting babies on their bellies to sleep can increase the incidence of SIDS or sudden infant death syndrome, as well as sleep related deaths such as suffocation.

Infant reflux is no fun, but most of the time it will resolve on its own. If you have any concerns or notice your baby showing symptoms of severe reflux, get your doctor’s advice.

For more information or to find a doctor or pediatrician at Henry Ford, visit henryford.com.

Metro Parent answers your top kids health questions here: metroparent.com/top-kids-health-questions/

Jenny Kales
Jenny Kales
Content editor Jenny Kales has been in the business of writing for more than 20 years. A natural storyteller, she loves helping Metro Parent clients tell their stories in a way that resonates with their audiences.


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