What is Reflux in Babies

Infant reflux is a condition where babies spit out the contents of their stomachs, often a short time after feeding. As the baby grows older, the condition becomes less common and it is quite unusual for the condition to persist after the baby has attained the age of 18 months or thereabouts. The major symptoms of the condition are spitting and vomiting, but as long as the baby is thriving, reflux is not a real concern as the baby will most likely grow out of the condition.

There are a number of reasons why babies may be subject to reflux. In the first place, the ring of muscular tissue that connects the esophagus, i.e. the gullet, to the stomach – the lower esophageal sphincter – is not fully developed in young babies so that, at times, it allows the contents of the stomach to flow backward into the esophagus. In time, as baby grows older, this sphincter will mature and perform its functions in the proper manner, i.e. it will open only when the baby swallows; at other times, it will remain tightly sealed thereby keeping the stomach’s contents in the stomach where they belong.

Another factor that increases the likelihood of reflux is that babies are lying flat for most of the time which makes it easier for the contents of the stomach to be sent backward. The fact that a baby’s diet is entirely liquid also makes it easier for reflux to occur, especially if the liquid gets mixed up with air bubbles in the stomach which may push the liquid backwards. In other cases, it may simply be the result of the baby having drunk too much, too fast. Although reflux will likely occur after feeding, it can actually occur anytime that a baby coughs, cries, or otherwise strains him or herself.

In a small number of instances, the occurrence of reflux may be a pointer to a more serious problem caused by allergy, blockage or disease, and certain signs in combination with reflux may be indicative of a need to see the doctor. Such signs include failure by baby to gain weight; refusal of food by baby; projectile vomiting, i.e. a forceful ejection of the stomach’s contents; spitting up blood or a greenish or yellowish fluid; the presence of blood in the baby’s stools; breathing difficulties; or if the vomiting begins after the baby has attained the age of six months. Any one of these signs or a combination of them may be indicative of more serious problems than mere reflux.

Gastroesophageal reflux disease (GERD), for instance, is one such possible condition and it comes about as a result of a high acid content in the reflux fluid which leads to damage being inflicted on the lining of the baby’s esophagus, i.e. the gullet. Another possible problem which these symptoms may indicate is pyloric stenosis, a rare condition in which the opening that leads from the stomach to the small intestine, i.e. the pylorus, is so narrowed that it prevents the contents of the stomach from emptying into the small intestine. The condition can also be exacerbated by allergic reaction by the baby to something that forms part of his or diet, very often, cow milk. Most cases of infant reflux will clear up on their own in time and will not be a cause of any problem to the baby. However, GERD or some other condition will lead to the baby displaying one or more of the symptoms listed above.

Where the reflux persists, say after the child’s first birthday, or otherwise gives cause for concern, then medical attention should be sought. The first person to see is baby’s pediatrician who may refer baby to a pediatric gastroenterologist, a specialist in childhood diseases of the digestive system. Following an analysis of the baby’s symptoms and physical examination, additional tests may be undertaken if the physician suspects something other than ordinary reflux. There are a number of tests which the doctor can choose to have done. Ultrasound or an upper gastrointestinal X-ray may be utilized to determine whether or not there are any blockages in the baby’s gastrointestinal tract whilst blood and urine tests can help to identify or rule out possible causes of persistent vomiting/poor weight gain. Whatever tests are chosen, the result will help to set in place a proper strategy to getting baby back on par. Depending on the results, a change in the baby’s diet (where allergy is implicated) may be recommended or appropriate medication prescribed (e.g. where esophagitis or chronic asthma is diagnosed). More often than not, nothing needs be done.

There are a number of simple steps that parents and care givers can take so as to reduce reflux in babies. Insofar as possible, the baby should be kept in an upright position. The baby should be fed in an upright position and, if possible, he or she should be kept upright for some time, 30 minutes, say, after feeding so as to allow gravity does its work in settling the stomach contents where they belong. Jostling or jiggling the baby ought to be avoided while the food is settling. Smaller, more frequent feedings can also help to reduce the condition.

Babies ought to be burped frequently during and after feeding so that air bubbles are not allowed to build up in the baby’s stomach; bubbles which, as we saw above, can cause an onset of reflux. The baby should be held in an upright position when burping and ought not to be burped over the shoulder as this method puts pressure on the baby’s abdomen and can result in reflux. Babies should also be placed on their backs to sleep, rather than on their tummies, so as to reduce pressure on the stomach.

Finally, it is well worth repeating that reflux is often just a passing phase that ought not to give rise to excessive concern; a handy collection of burp clothes will suffice to see parent (care giver) and child through the reflux stage of the child’s development.