Infant Acid Reflux

What is infant acid reflux?

Infant acid reflux, or “spitting up,” happens when the contents in your baby’s stomach, like milk or stomach acid, comes back up into their esophagus and throat. Infant acid reflux is common in infants, and you might see them spit up their milk or food. It's a normal occurrence and is usually nothing to worry about.

What causes acid reflux in infants?

Babies have developing digestive systems. Eventually, as they get older, their lower esophageal sphincter — located where their esophagus meets their stomach — will close so that food and stomach acid don’t flow backwards into the esophagus. But as babies, this sphincter is still pretty weak and doesn't close properly.

When babies fill up on milk, their stomach contents can easily push back up into the esophagus, since these muscles aren’t strong enough to keep it down. This allows the milk to come back up into the esophagus and throat.

Symptoms of infant acid reflux

If you have a “happy spitter,” here are some reflux symptoms you may notice:

• Frequent or occasional spit up
• Extra burping or hiccups
• You’re doing a lot more laundry!

How long does acid reflux last in infants?

Every baby is different, but usually babies outgrow acid reflux by 12 months of age. This is usually the age when the lower esophageal sphincter closes and matures.

Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease, or GERD, can occur when spitting up is more severe. GERD in infants can cause irritation or damage to the esophagus from stomach acid, and can be super uncomfortable. While GERD in infants isn't common, here are some signs and symptoms to watch for:

• Refusing to eat
• Extreme crying and fussiness or colic
• Gagging on spit up
• Projectile vomiting (can be a red flag)
• Spitting up blood (can be a red flag)
• Frequent coughing
• Poor weight gain

What puts a baby at higher risk for gastroesophageal reflux disease?

Here are some factors that may increase the risk of developing GERD in infants:

• Prematurity
• Neurologic disease
• Anatomic abnormalities
• Feeding difficulties/aversion

What is silent reflux?

Silent reflux occurs when the stomach's contents push into the esophagus, without coming out of the mouth. In silent reflux, symptoms of reflux are "silent," and you won't see spit up because your baby swallowed it.

Treatment for GERD

GERD is uncomfortable and can be painful too. Here are some treatments options to relieve symptoms of GERD:

Avoid overfeeding

When babies have super full bellies, the contents in their stomach are more likely to push up into the esophagus and throat.

Keep your baby upright after feedings

Think of it like using gravity's help. Keeping them upright for 20 to 30 minutes after they drink from a bottle or breastfeed gives the milk time to go down through the esophagus and settle in the stomach to start digesting.

Change the feeding schedule

Rather than giving your baby fewer, bigger meals, consider offering smaller meals more often. This way, they won’t have to digest a large volume of milk at once, which could help ease the strain on their stomach and reduce acid reflux.

Burp throughout feedings

Burping during feeding sessions can help lessen GERD symptoms. Consider burping your baby 2 or 3 times during and after feedings to see if it helps with regurgitation.

Change their diet

If your baby is formula-fed, talk to your local pediatrician or your Summer Health pediatrician about a formula switch. Sometimes switching to a dairy-free or hypoallergenic formula can help. If your baby is breastfed, try removing dairy or soy from your diet to see if symptoms improve.

If your baby is not responding to any of these treatments, schedule a pediatrician visit.  In some cases, your pediatrician will refer you to pediatric gastroenterology for an evaluation.  

When to ask for help

If your baby shows any of the following signs or symptoms of GERD, reach out to your local pediatrician or your Summer Health pediatrician as soon as possible:

• Blood streaks in spit up
• Bloody vomiting
• Bile in vomiting
• Forceful or projectile vomiting
• Refuses to feed
• Bloody stools
• Difficulty breathing
• Wheezing during feedings
• Arching the back during feeding (sign of pain)

It's normal for babies to experience acid reflux. But if you notice signs of GERD in your little one, don't hesitate to reach out for professional support. And remember, the Summer Health team is ready to help – we’re only a text away.