Your Baby and Reflux

Kelly Cullerton, OTD, OTR/L

What is Reflux:

After your baby swallows their food, it travels down a tube called the esophagus into their stomach. Reflux occurs when that food is pushed out of the stomach back into the esophagus. Sometimes the food comes all the way up the esophagus and out of the babies mouth as “spit up”. However more often, the food only comes part of the way up the esophagus, and then goes back down, giving no obvious sign that it occurred. Even though we might not always see it, this is still reflux, and can still be very uncomfortable for your baby.

Signs of Infant Reflux:

  • Spits up food out of mouth

  • Ask fussy/irritable during or between feeds

  • Refuses to eat

  • Eats very small amounts during feeding

  • Arches back and throws head back during feed

  • Is very wiggly during feats

  • Appears uncomfortable during feed

  • Poor weight gain

  • Breathing sounds wet or stuffy

  • Wet sounding burps and hiccups

Feeding the Infant with Reflux:

Infants with reflux may face additional challenges during feeding. But there are several science-based strategies that can help you and your baby have a better feeding experience.

Use a nipple with a slower flow

  • Too much milk entering the stomach too quickly increases the chance of it refluxing out

  • Certain bottles are designed so that the milk flows out slower, slowing its entry into the stomach

Allow your baby to take breaks

  • Infants with reflux often benefit from extra time within their feed for burping and digestion

Consider offering smaller, more frequent feeds

  • Consuming large volumes of at a time can increase the likelihood of reflux

  • Try offering your baby less formula at each feed, and offering more feeds throughout the day

Always follow the babies cues

  • Feeding should be infant-driven. This means it is the babies decision if and how much they consume at a given feed.

  • Watch your baby during the feed for signs that they are done, need a break or need to slow down.

Formulas For Infants with Reflux:

Some infant formulas are designed specifically for infants with reflux. These formulas have helped many babies experience less reflux each day.

  • “Anti-reflux” formulas are a usually slightly thicker liquid than other formulas. Being thicker helps the formula “stay down” in your infants stomach and less likely to reflux out

  • Some anti-reflux formulas are sold in a ready-to use liquid form and others are a powder that you mix with water

  • Choosing between a ready-to-use or powder formula depends on your budget and preferences

  • After mixing a powdered formula, be sure to let access bubbles settle before feeding.

Swallowing air bubbles will increase gas in your baby stomach, increasing the chance of reflux

Positioning

The way you position yourself and your baby while feeding can help make it a more positive experience for both of you.

During the Feed:

Find a comfortable position for you and baby

  • Feeds may take up to 30 minutes. Settle into a comfortable position that saves your back neck and arms from unnecessary discomfort.

  • Consider placing a pillow under baby

After the Feed

  • Keep the baby upright

  • Keeping baby in an upright position for 30 minutes after the feed is recommended for infants with reflux. When this isn’t realistic, aim for however long that you can hold or remain directly with them

  • Avoid pressing on or laying baby on their stomach.

  • **Sleeping infants should only ever be positioned on their back, a firm, flat surface***

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