Reflux happens when some stomach contents (e.g. breastmilk) pass from the stomach back up into a baby’s oesophagus (muscular tube that leads from the mouth to the stomach), and sometimes spills out her mouth. Reflux is very prevalent in newborns, also called spitting up or regurgitation. Gastro-oesophageal reflux, or GOR, is the medical word for reflux. It may lead to gastro-oesophageal reflux disease or GORD if GOR is more severe or has complications. Spitting up doesn't bother the child and may not seem noticeable to your child. Reflux is different from vomiting. Vomiting is stronger, generally more than a tablespoon or two, and annoys the baby.
If a baby with reflux is otherwise happy and putting on weight well, this is called ‘simple reflux’. It doesn’t hurt the baby and it usually stops by itself as the baby grows.
There is also ‘reflux disease’ which is a medical problem and requires medical advice.
The following symptoms may indicate reflux disease, which needs medical advice:
- Your baby is bringing up a large amount of milk after most feeds.
- She seems to be in pain after breastfeeds.
- She is fussy and unhappy between feeds.
- She arches her back after most feeds.
- She has problems gaining weight.
- Ongoing breathing (respiratory) problems.3
Here are some things you can do to minimize the level of reflux your baby may experience:
- Make every feed calm and relaxed.
- Hold your child upright, not lying down while you feed them.
- Feed your baby in smaller amounts at one time.
- Feed your child without interruption. If the child has been crying long before a meal, they may have taken air. Spitting up is more probable if at the start of a feeding the child has air in the stomach.
- Burp your baby several times each time you feed. It works best to support the head of the infant and burp them on your lap. Burping your baby over your shoulder can put too much pressure on their stomach.
- Keep your child upright after eating for 30 minutes. An infant seat or car seat works fine.
- If you're supervising your child, you can put them on their tummy for an hour or so after the feed. Take care not to let your baby sleep on their tummy due to the connection with sudden unexpected death in infancy. Always put your child on their back to bed.
- Make sure nappies aren't too tight and don't place stress on the baby's stomach.
When to see your doctor about reflux
If your child is otherwise safe and pleased and they're just bringing up milk, nothing requires to be done. Talk to your physician or maternal health professional if: you have any other concerns that your baby is not gaining weight, there is a shift in bowel movements or your baby's urination displays indications of distress or pain.
Sources: https://www.pregnancybirthbaby.org.au/reflux. Raising Children Network (Gastro-oesophageal reflux and GORD). Infant Support Association (Management tips – reflux. Sydney Children's Hospitals Network (Reflux) https://www.breastfeeding.asn.au/bf-info/common-concerns%E2%80%93baby/reflux