Reflux baby: What is newborn reflux and how do you treat it?

What is baby reflux?
Reflux is when babies bring up small amounts of milk out of their nose or mouth, along with air. It’s sometimes called spitting up or posseting. 

Reflux is when the contents of the stomach come back up into the food pipe (oesophagus) or mouth. It’s very common in newborns and often doesn’t cause any discomfort. 

What are the signs of reflux in babies?
If your baby spontaneously regurgitates small amounts of milk during, between and after feeds, they probably have reflux.
Reflux is not the same as vomiting. Vomiting is forceful and is more than a tablespoon or two. It can be a sign of illness.

What causes reflux?
In babies, it occurs because the sphincter, the muscle at the top of the stomach, is loose or relaxed because it’s not fully developed. It can also be caused by air bubbles in the stomach or by eating too much too quickly.

It usually peaks at about four months and by seven months many babies have outgrown it. Most children have outgrown it by the time they’re toddlers.

Most cases of newborn reflux are mild and don’t require any treatment. But if your baby is uncomfortable, you can try some of these tips:
• Try to keep your baby as upright as possible while feeding and for about 30 minutes after a feed.
• Try to feed them smaller amounts at a time.
• Don’t delay feeding. If your baby has been crying for a long time before a feed, they may swallow a lot of air.
• Burp them several times during a feed.
• Put them on their tummy for a while after a feed, with you supervising. Don’t put them to sleep on their tummies.
• If you’re bottle feeding, check the size of the opening in the teat. If the hole is too big the baby will drink too quickly and spit up the excess. If the hole is too small the baby has to suck very hard and will swallow air.

What is gastroesophageal reflux disease (GORD)?
In some babies and children, reflux can cause complications and lead to gastroesophageal reflux disease (GORD). If your baby has pain and discomfort in their stomach and chest, has difficulty feeding, is not gaining weight, cries a lot and arches their backs before, during and after a feed, these could be symptoms of GORD. You should see a doctor to confirm a diagnosis.

Your doctor might try pH monitoring: checking the acid levels in your child’s oesophagus by placing a tiny tube with a sensor in their oesophagus for 24 hours.

Studies have found that using a feed thickener or thickened formula can help reduce the symptoms of GORD. Thickener can be used in expressed breast milk or formula or it can be mixed and given as a gel during breastfeeding.
If your child seems to be in pain after vomiting or isn’t gaining enough weight, your doctor may prescribe medication such as an acid suppressant.

What causes reflux in pregnancy?
Acid reflux, which causes discomfort, a burning sensation behind the sternum and throat and a bitter or sour taste in the mouth, is very common during pregnancy.

It can be caused by hormones, eating a big meal, doing physical activity soon after eating and eating certain foods. Take note of which foods seem to affect you. Some foods to avoid include chocolate, peppermint, fruit juice, caffeine and anything high in fat.

Eat smaller meals more often and don’t lie down just after eating. If your stomach acid is severe, medication can help to neutralise it.

What is silent reflux and how can it be treated?
Laryngopharyngeal reflux (LPR) is also known as silent reflux because it doesn’t trigger the usual symptoms of acid reflux. It develops when the stomach acid travels through the food pipe and reaches the back of the throat. It can lead to hoarseness, frequent throat clearing and coughing and can damage the throat and vocal cords. It can affect adults and children.

You can treat it with lifestyle changes such as those listed above and medication. Some people swear by natural remedies for reflux and heartburn such as melatonin, calcium (the active ingredient in many antacid medications) and herbal remedies.

But there isn’t enough evidence of their effectiveness and some supplements can have side effects or interfere with medications, so check with your doctor before trying any.