Babies often spit up after eating because their digestive systems aren’t fully developed. This condition—known as acid reflux or gastroesophageal reflux (GER)—rarely causes problems, and it usually disappears as your little one ages. However, extreme acid reflux symptoms may point to another problem, such as gastroesophageal reflux disease (GERD).
What Causes Acid Reflux in Babies?
Your baby’s gastrointestinal system (particularly the lower esophageal sphincter) is still developing. Since his stomach might not work properly, the contents sometimes make their way back up the esophagus, leading to spitting up or vomiting. Acid reflux is common among healthy babies, and unless it interferes with feeding or well-being, parents should have little cause for concern.
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Signs of Acid Reflux in Babies
If your baby exhibits the following symptoms, he may be experiencing acid reflux.
- Spitting up and vomiting. Although all babies spit up, those with acid reflux may do so more often or forcefully.
- Poor feeding. Since reflux causes irritation in the esophagus (heartburn), your baby might not eat normally. She might arch her back and retract from the nipple while breastfeeding.
- Fussiness. Babies with reflux may act irritable or fussy after feedings.
- Breathing issues. Babies with reflux may cough, wheeze, and experience congestion when stomach acid gets into the upper airways. These symptoms may worsen when your little one lies flat.
- Hiccups. Hiccups and wet burps are more prevalent in those with reflux. They’re caused by excess air in the belly and esophageal irritation.
When Does Acid Reflux Go Away?
According to Alan Greene, M.D., FAAP, the peak age for reflux is about 4 months, and most babies have outgrown it by 7 months. That’s when the esophageal sphincter muscle develops enough to close properly. It’s rare to have reflux after 18 months of age.
Could It Be GERD?
If acid reflux is severe, your baby might have gastroesophageal reflux disease (GERD)—especially if symptoms last past 12 to 14 months of age. Besides the symptoms listed above, other signs of GERD include failure to gain weight, trouble sleeping, frequent vomiting, and respiratory problems like recurring pneumonia or wheezing. Some babies with GERD may also display symptoms of colic (unexplained crying for more than three hours a day, more than three days per week). Talk to your child’s doctor if you suspect GERD.
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Natural Remedies for Acid Reflux in Babies
If your baby is showing signs of reflux, consider these natural remedies for the digestive problem.
Breastfeed, if possible. Breastfeeding is best for a baby with reflux, since littles ones digest milk twice as fast as formula. If breastfeeding isn’t possible, talk to your doctor about which formula is best for your baby. Sometimes switching to a hypoallergenic or lactose-free option can help relieve symptoms.
Keep Baby upright after feeding. Keeping your baby in a sitting position during feedings—and for at least 20 minutes afterward—can prevent food from traveling upward into the esophagus.
Give frequent but small feedings. This will be easier on Baby’s stomach and also decrease reflux because there is less to regurgitate. Some babies with reflux naturally prefer to eat this way; others get cranky if they don’t get their full feeding right away. After a few days, though, your baby should adjust to this new schedule, so try to stick with it.
Burp often. You might want to stop feeding every two to three ounces to burp Baby. Burping will release gas and relieve the symptoms of reflux.
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Delay playtime after meals. Avoid jostling or bouncing Baby right after a feeding; all that movement increases the likelihood of spitting up or vomiting.
Avoid tight diapers and clothing. Tight items can put added pressure on Baby’s tummy and make him especially irritable.
Change your diet. Some foods, such as dairy products or gas-inducing vegetables like cabbage, may increase reflux. Consider eliminating these items from your diet if breastfeeding.
Check nipple size. A bottle-fed baby may swallow too much air if the nipple is too small or big.
Thicken your baby’s milk. Some pediatricians recommend adding some rice cereal to formula or expressed milk to make it easier to digest. This will also slow down your baby’s intake. Always talk to your doctor before trying this method, since rice cereal adds extra calories.
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Medical Treatment for Acid Reflux
In most cases, acid reflux in babies will go away with natural remedies. However, if your baby’s reflux isn’t improving—or is actually getting worse—talk to your pediatrician about a prescription medication to relieve the symptoms. According to Dr. Greene, “Usually we only use medication if the child is not growing well, has a chronic cough or trouble breathing, or seems to be in pain—not for just spitting up.”
While no drug is totally free from side effects, rest assured that many of the most common drugs given for acid reflux are very safe and effective. And since most babies outgrow acid reflux before their first birthday, they usually don’t need to take the meds for very long.
Acid reducers (like Zantac) are usually the first choice, and proton pump inhibitors (like Prevacid and Prilosec) are reserved for more aggressive cases. According to Dr. Greene, “Zantac is a medicine that decreases the acidity of what sloshes up. Whether the benefits outweigh the possible side effects depends on how severe the symptoms are.”