Many moms notice that their baby has reflux when they spit up more frequently. Reflux in newborns1 is very normal, since the digestive system at this stage is still very immature, but sometimes a first-time mom may not immediately identify the symptoms of reflux in newborns and the problem can get worse if proper care is not taken.

What is Reflux?

To understand reflux in newborns, we need to know that the digestive system has acids responsible for digesting food that goes to the stomach, and in the case of newborns, this food is only liquid and easier to come back up. The milk, whether it is breast milk (preferably) or formula, can come back up, causing the well-known “spit-up.” Gastric reflux is nothing more than the stomach contents that come back up the esophagus, and usually this reflux has mixed gastric acid which causes the reflux to hurt wherever it passes, because besides the stomach, the other organs are not prepared for the aggressiveness of gastric juice2. That’s why it is so important to check the degree of reflux in newborns, because the only way the baby can communicate is by crying, and if they are in pain, they become even more sensitive. Usually, babies have reflux episodes, and this is normal to a certain extent. A baby who has daily episodes, at almost every feeding for example, may have a more complicated form of reflux in newborns.

What Does Reflux Look Like?

The liquid that comes up is curdled and smells “sour” like a runny yogurt with little pieces, and some babies will spit up this “cream” just 10 or 15 minutes after nursing. Reflux is normal and very common among newborns, and it only becomes significant when the problem starts to affect the baby’s weight gain. In some cases, it can also make feeding more difficult, since the acid can hurt the esophagus and throat. Clear signs of reflux in newborns can be:

Signs of Reflux

  • Restlessness after feedings
  • Frequent spit-ups
  • Coughing after and during spit-ups
  • Irritability during feeding
  • Less or no weight gain
  • Signs of respiratory problems in older babies
  • Restless sleep

How to Diagnose

The diagnosis is usually made by the pediatrician in the office during routine visits, and the symptoms may be clear, but some imaging tests may be requested. These tests are rarely ordered, because it is necessary to give the baby a contrast solution and the baby’s reaction to this substance is unknown—they could be allergic.

How to Treat Reflux

Treatment for reflux with medication in newborns is simple, anti-reflux medication Domperidone and Label every 8 hours, but the pediatrician must prescribe the right dosage for the baby3.

How to Prevent Reflux

Tips can help reduce reflux in babies, and sometimes medication is not even needed to eliminate the symptoms. For example, keeping the baby more upright after feedings is a big help to prevent reflux. Nowadays, there are baby bouncer seats that can help moms keep the baby a little more upright after feeding, notice that the baby stays kind of sitting up. Another technique used is to slightly elevate the baby’s mattress or use anti-reflux pillows for babies. Giving less milk at each feeding and feeding more frequently can also help; a very full stomach promotes reflux more easily. Sleeping on their side is a good position for the baby; this avoids any risk of choking from reflux.

A Reader’s Experience

Viviane recently heard the news at the pediatrician’s office during a routine checkup—she took her one-month-old Rafick for a visit and described the symptoms. Rafick is currently undergoing treatment for reflux. See Viviane’s account below. Rafick coughed a lot and also cried. Besides spitting up frequently, I took him to the pediatrician who prescribed some medications and procedures to improve the reflux. I started using Peridal and Label. I stopped Peridal because I did not see any results and continued with Label, which is a type of anti-inflammatory; with it, I noticed a slight improvement in the irritation. I saw that small physical and postural changes would help my baby suffer less from reflux.I started to elevate the head of the bed at a 30-degree angle, keep the baby upright for 40 minutes after feedings, and shorten the interval between feedings—that means he drinks less milk, but more often, avoiding the stomach getting too full and thus lessening the reflux. Mom, pay close attention to the symptoms and the reason for the baby’s crying. If he cries a lot for no apparent reason and is losing weight or not gaining weight as he should, it is essential to take him to a trusted pediatrician for an evaluation. Remember that spitting up can be normal up to one year of age, but if your baby is “spitting up” or vomiting a lot, it’s always good to have an evaluation with a specialist. However, reflux is not always associated with spit-ups, so moms should keep an eye on the signs either way, even if there’s no vomiting. Reflux is normal and will pass; just follow the treatment and procedures correctly and everything will be fine in the end. Kisses and see you next time! Also see: First Food: Baby’s First Puree Photo: Daniel Peinado