Reflux

The very common phenomenon of babies spitting up some milk right after or in between feeds is called ‘Reflux’.

Many infants spit up milk. It can be curdled sometimes. This is observed commonly and the reason is that – the digestive system of the babies are still not mature and therefore the milk, even after entering the stomach, can flow back up into the oesophagus (more commonly referred to as the food-pipe, connecting mouth and stomach) and from there into the mouth of the baby, causing the spit-ups. In most cases, these spit-ups are in small quantities and do not cause any discomfort to the baby. These babies are called happy spitters. They are seldom bothered by the spit-ups and are otherwise developing well. In such situations, reflux is not a reason to worry. Parents can still use some of the following tips to tackle the spit-ups.

Tips to address mild to moderate Reflux:

1. If there’s an overactive letdown, change positions to ensure that baby is comfortable and isn’t guzzling down too much milk at once.
2. Positioning the baby in such a way that her head is higher than the rest of her body while nursing.
3. The latch should be checked to minimize swallowing of air while nursing.
4. Frequent, short feeds are better in controlling reflux as compared to nursing sessions with big intervals wherein the baby gulps large quantities at once causing load on the stomach.
5. Keeping the baby in upright position and burping after every feed, and during or in-between feeds if need be; can help.
6. Avoid giving tummy time immediately after feeding.

It is often mentioned that little bit of spitting up every now and then is common and normal. There isn’t a cause of concern unless it is projectile vomiting. Let’s consider when spit-ups are not normal.

Excessive Spit-ups:
Excessive spit-ups are not normal when coupled with a lot of discomfort in the baby with low weight gain and poor growth. Some of the reasons for excessive spit-ups involve the following.

• Oversupply (This can be addressed and does not require any treatment for the baby). See our article on oversupply here.
• Overactive and forceful letdown (This too does not require treatment for the baby). This is often a part of oversupply. Read our article on oversupply here.
• Food sensitivity/Allergy (Allergy to foods that the mother might be consuming in large quantities could be one of the reasons for excessive reflux in babies. Analysing the mother’s diet and eliminating the food causing the issue solves the problem)
• GERD (Gastroesophageal Reflux Disease) can be responsible for excessive spit-ups and projectile vomiting. Read more about it here.
• Pyloric Stenosis (It is a rare medical condition that requires a medical diagnosis through ultrasound or barium swallow. The treatment usually involves surgery through laparoscopy or pyloromyotomy).

References :
https://www.llli.org/breastfeeding-info/reflux/
https://kellymom.com/hot-topics/reflux/
https://themilkmeg.com/category/baby-reflux-and-spitting-up/