Feeding and Digestive Issues: Reflux
Since your newborn’s digestive system is still maturing, a small amount of spit-up or even vomit after a feeding is normal and eventually outgrown. A more serious condition, however, is Gastroesophageal Reflux Disease (GERD). Similar to what we adults would call heartburn, GERD is when the acidic stomach contents return up the esophagus and cause painful irritation, abdominal discomfort, spit-up and sometimes vomiting. The reason it’s so common in babies under a year (especially preemies) is because sometimes the barrier-like muscles at the bottom of the esophagus are too underdeveloped to keep food from backing up during the digestion process. GERD usually develops around now (two weeks) and can last the rest of the first year or even longer, but the symptoms will be the worst during the first few months.
What to look for:
- Inconsolable crying that sounds like he or she is in pain
- Unusually large amounts of spit-up and drool
- Projectile vomiting
- Little weight gain
- Trouble sleeping
- Choking or gagging while eating
- Signs of abdominal pain, like back arching or curling up
- Constant burping or hiccupping
- Chronic coughing, often causing a sore throat and/or respiratory problems
- Frequent ear infections
If the vomiting is exceptionally violent and projectile, this could be pyloric stenosis, a serious condition where the pylorus muscle, located in the lower part of the stomach, thickens and blocks food from entering the small intestine. This needs to be addressed immediately, as babies suffering from pyloric stenosis aren’t getting any nutrients and will need surgery.
While there isn’t much treatment for GERD (the doctor might prescribe a medication to reduce or neutralize stomach acid in more severe cases), fortunately almost all babies outgrow it – it’s just a matter of making him or her as comfortable as possible until then. There are some measures you can take to reduce the pain:
- First of all, if you’re breastfeeding, try and continue doing so for as long as possible. We know this isn’t always an option, but breast milk -a natural antacid – is more quickly digested than formula, making it less painful.
- Feed your baby more frequently but in smaller portions. (If the problem continues until the solid-food stage, avoid large amounts of acidic or fatty foods.)
- Burp your baby more often than normal
- Sucking can sometimes reduce reflux, so try giving a pacifier after a feeding.
- Make sure your baby stays upright for at least an hour after a feeding. Since babies tend to drift off while noshing, there are wedge-like pillows babies can be strapped into for reflux purposes.
- Ask your doctor about adding rice cereal to the baby’s formula.
When to call the doctor:
Although most cases of GERD can be successfully managed at home, call the doctor if symptoms persist after trying the aforementioned suggestions – especially if the baby isn’t gaining weight or sleeping. In rare cases GERD can cause choking, pneumonia or even apnea.