Infant acid reflux—also known as gastroesophageal reflux—is a used to describe a condition in which stomach contents come back up into the esophagus and mouth. Here are 11 tips of feeding babies with infant acid reflux.
A baby with reflux should always be in an upright position during and after feedings for at least 30 minutes, says Isa Marrs, a specialist in children's feeding disorders in New York. The crib mattress also should be elevated on the side where the baby's head rests while sleeping to decrease night episodes of reflux.
"Your baby's head also should be elevated during diaper changes," Marrs says. "A young baby especially spends a lot of time having his diaper changed and this time should not be ignored." Marrs recommends consulting your doctor or a therapist for additional information on safe ways to improve positioning of a baby with reflux while feeding and sleeping.
A "good" bottle has a "slow flow nipple" for bottle-fed babies, says Dr. Boriana Parvez, a pediatrician and neonatologist in New York. Before starting to feed, fill the entire nipple with fluid to prevent swallowing of air and swelling of the stomach, she says. "Hold the baby on his or her side with the left side up during the feeding, and at least one hour after feeding. This position is more conducive to stomach emptying."
Breastfeeding mothers should express some breast milk prior to putting the baby to her breast, Dr. Parvez says. This helps to decrease the flow of milk, which will prevent the baby from "gulping." In turn, this gulping can cause rapid stomach swelling. Breastfeeding mothers should decrease the consumption of "gas-producing foods," such as beans, cabbage, and spices, Dr. Parvez says. "If there is a strong family history of cow milk allergy, breastfeeding mothers should reduce the intake of cow's milk and cow's milk products as well as cheeses.”
It's been shown to be helpful to feed a baby with reflux more frequently with smaller amounts. "When a baby eats too much at one time, reflux can get worse," Marrs says. "Some babies with reflux will do this all on their own because they learn if they eat too much, they end up in pain."
More frequent burping is another way to avoid episodes with reflux. "Depending on how much your baby is drinking, a burp every 2 to 3 ounces would be helpful," Marrs says. During her sons' first six months, Heather Martin from Franklin, Massachusetts, always made sure she burped her son during after feedings. This seemed to ease his reflux symptoms.
During feeding time, your baby can detect when Mom or Dad is upset or nervous, says Nicole Barker from San Antonio, Texas, whose son has reflux. "Try to stay calm and realize that feeding time should be a peaceful, bonding experience—one that your little one and you should welcome and enjoy."
Thickening Baby's formula with rice cereal may improve reflux. "Usually 1 ounce of cereal to 2 ounces of formula is recommended," Marrs says. "This also can be done with breast milk although breast milk is thinner, and may require more thickening." Note: This should be done with caution, as it may lead to constipation and make digestion harder, cautions Dr. Parvez. Always consult your doctor before changing your baby's feeding routine.
Sometimes, a formula change is necessary. A baby may be allergic to a milk-based formula, which can cause symptoms of reflux, Marrs says. Switching formulas, or stopping breastfeeding and going to formula, should be nearly a "last resort" if other strategies fail, according to Dr. Parvez. Again, your baby's pediatrician or a feeding specialist can make more specific recommendations tailored toward your baby's specific needs.
While medication is always a last resort, Marrs says, it's frequently used in babies with reflux. For Martin's sons, the combination of Zantac and Enfamil AR immensely improved their condition. Along with smaller amounts fed to their baby, medication made a huge difference in his demeanor, the parents' stress levels... and the huge laundry pile, says Miranda Barnard of Salt Lake City, Utah. (Fewer clothes that have been spit up on!)
"Trust your gut instincts," Barnard says. "If you feel that your 'colicky' baby is having issues other than just being fussy, don't be afraid to bring it up with the pediatrician until a solution is found. My friend's baby with reflux didn't respond well to the first medication that was prescribed, so she pressed on and tried another until they found something that worked. All babies are different, so sometimes you have to try a few things until something works." Marrs recommends seeing a feeding specialist or a pediatric gastroenterologist prior to placing your baby on any medication for reflux. As with any medication, there are always side effects to be concerned about. Consult your doctor about those as well.
The good news is that most babies eventually outgrow reflux, Dr. Parvez says. "The key is not to give in easily to the urge to switch formula, to add anti-acid medication, or to blame oneself," she says.