New parents expect spit up during the first few months with a new baby. But, when your baby won’t stop crying and spit up involves an occasional bout of projectile vomit, you may be dealing with gastroesophageal reflux (GER).
GER is the backing up stomach contents into the esophagus. Babies can suffer from the same burning and discomfort adults experience with this condition. Though reflux isn’t usually serious, it can be uncomfortable for baby and exhausting for parents.
Understanding Your Baby’s Developing Digestive Tract
Don’t believe that well-intentioned – or not so well-intentioned – neighbor who says your stress is making your baby spit up and cry. Reflux is common even amongst the healthiest of infants.
The true cause? An underdeveloped digestive tract. In infants, the small ring of muscle between the esophagus and the stomach hasn’t fully matured, allowing stomach contents to enter back into the esophagus. Not all babies experience pain with GER, while others can become inconsolable.
When It Might Be More Serious
Infant reflux is rarely serious, but you should see a doctor if your baby:
- Isn’t gaining weight
- Projectile vomits (consistently spits up with enough force to shoot out of the mouth)
- Has a cough that won’t go away
- Spits up blood and/or has blood in his or her stool
- Frequently cries during or after feedings
- Begins spitting up after six-months-old
These signs and symptoms could be from gastroesophageal reflux disease (a more serious form of GER) or other serious, but treatable, conditions. For babies that have more severe reflux, there is help available.
“If your baby has a more severe degree of reflux,” says Dr. William Sears, “your doctor may prescribe medicines that lessen the production of stomach acids.”
Good News for GER
The good news is most children outgrow GER by the time they turn eighteen months old. As the body continues to grow and develop, the muscle at the opening of the stomach gets stronger, stays closed, and prevents food from getting back into the esophagus.
Getting through the long days and even longer nights with a baby suffering from GER can be tough, but you aren’t alone. Gradually, you baby’s distress will disappear. There are steps you can take to lessen the effects of GER and help your baby be more comfortable.
1. Breastfeed, if Possible
Breastmilk is naturally hypoallergenic and digests at twice the speed of formula. But don’t beat yourself up if you can’t breastfeed. Both breastfed and formula-fed infants struggle with GER. Switching to a hypoallergenic or lactose-free formula can help as well.
2. Go for Small, Frequent Feedings
“Feed your baby twice as often, half as much,” recommends Dr. Sears. With less food in the stomach, there is less volume to spit up. A smaller volume will also be digested faster.
3. Thicken Milk or Formula
Some pediatricians recommend thickening formula or breast milk with a small amount of rice cereal. In theory, this keeps fluid from coming up into the esophagus. However, this doesn’t work with all babies and doesn’t relieve other reflux symptoms, but it might be worth a try.
4. Keep Baby Upright
Use gravity to your advantage by keeping your baby in an upright position for at least thirty minutes after feeding. Your baby will have less pressure on the muscle at the entrance of the stomach and extra time for digestion. You can take this time to cuddle your baby in your lap or some other quiet activity.
5. Burp Often
Getting air bubbles out of the stomach can help relieve pressure. For breastfed babies, burp each time your baby comes off the nipple. Bottle-fed babies should be burped after every two to three ounces of formula.
6. Adjust Sleep Position
Night time can be particularly hard for babies with GER. Without the aid of gravity, food easily enters the esophagus. Babies that don’t seem to struggle at night need nothing more than sleeping on their back on a firm mattress with no pillows, blankets, or toys in the crib.
For babies that frequently cry, have wet burps, or sour breath at night, elevating the crib mattress thirty degrees can help keep food down.