Acid Reflux in Babies—What’s Normal, What’s Not, & When to Seek Help

By: Caroline Hilla 

The nights are long, and I mean really long.
 
Every baby has their ‘fussy’ moments, but at what point does your little one seem more irritable than normal? Screaming for hours with a bright red face, clenched tight fists, with no chance of settling down. Seeing your baby in pain feels like torture!

Now, imagine the worst possible heartburn you’ve ever experienced, but then put it in a newborn baby’s body #ouch. You can’t blame them for screaming for hours on end with no method of communicating their pain to you.

What is Reflux? And how can I identify it? 

So, what is this “reflux” or “silent reflux” you’ve been reading about on WebMD? Infant Reflux is when the contents of the stomach are backed up and washed back into the baby’s throat.

Common Infant Reflux Symptoms:

1. Spitting up and vomiting
2. Refusal to eat and difficulty eating or swallowing
3. Irritability during feeding
4. Wet burps or hiccups
5. Failure to gain weight
6. Abnormal arching
7. Frequent coughing or recurrent pneumonia
8. Gagging or choking
9. Disturbed sleep

It is perfectly normal for a baby to spit-up or vomit every once in a while, after feeding. While most infants outgrow this occasional reflux, some babies can develop more severe reflux such as Gastroesophageal Reflux Disease GERD.

Untreated GERD can lead to more serious medical problems for infants, and should therefore first be evaluated by a medical professional.

Why do Babies get Reflux? 

Babies are not born with fully developed digestive systems and must first train their esophagus and stomach muscles to properly swallow and digest food. To be more specific, the sphincter in the esophagus is immature and doesn’t close properly. Reflux is a common result of the undeveloped sphincter resulting in milk and acid coming back up the food pipe.  Around 40% of babies experience reflux with 5% of these having five to six episodes per day. Reflux is a temporary problem that usually gets better as your baby’s digestive system matures, however those with more severe cases are advised to seek medical advice.

Is it colic or reflux? 

Your screaming baby may be dealing with more than just colic. So, what’s the difference between colic and reflux and how are they related?

Colic can be defined as uncontrollable, extended crying in babies who are otherwise healthy and well-fed. All babies cry, but when they cry for more than three hours a day, three to four days a week, they are said to have colic. Colicky babies can feel very uncomfortable as a result of swallowing lots of air during long crying spells. This can cause infants to feel gassy and irritable. Untreated cases of reflux can sometimes be the cause of colicky behavior. In such cases, treating the reflux could completely eliminate the colic.
 

When should I see a pediatrician? 

Recognizing the symptoms of severe acid reflux in newborns is helpful when deciding whether or not to consult your family pediatrician. If your baby has one or more of the following symptoms, it is recommended to consult your pediatrician for professional medical advice:

• 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
• Spits up blood or a material that looks like coffee grounds
• Refuses food
• Has blood in his or her stool
• Has difficulty breathing or a chronic cough
• Begins spitting up at age 6 months or older
• Is unusually irritable after eating (on a regular basis)

Pediatricians may advise infants with severe reflux to try anti-acids, eliminate cow’s milk, or use feed thickeners. Every baby is different, therefore please consult with your Pediatrician before determining which treatment options best fit your baby’s needs.

Tips for preventing reflux

• Hold your baby in an upright position for 30 minutes after each feeding
• Try smaller more frequent meals
• Feed your baby in an upright position
• Try burping your baby every 3 minutes while feeding
• If bottle-feeding, use a bottle with a slow flow nipple. Using a flow rate bottle while pace feeding is a great way to reduce reflux. mimijumi is a slow flow bottle baby bottle designed to mimic a mother’s breast in form, feel, and function.

Remember, never feel apprehensive to consult your Pediatrician, because no one knows your baby better than you do. Understanding the basic ins and outs of acid reflux in infants will help you to identify common symptoms and potentially relieve your baby of the pain they may be experiencing.