Acid Reflux in Babies: Causes, Symptoms, and Remedies

Acid reflux occurs when the stomach contents move upward into the esophagus. Here's what parents need to know about this common newborn digestive problem. 

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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).

Causes of Acid Reflux in Babies

Your baby's gastrointestinal system (particularly the lower esophageal sphincter) is still developing. Since their stomach might not work properly, the contents sometimes travel 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.

Signs of Acid Reflux in Babies

If your baby exhibits the following symptoms, they 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. They might arch their back and retract from the nipple while breastfeeding.
  • 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 babies 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 around 4 months, and most babies outgrow it by 7 months old. 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.

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 babies with reflux since they digest milk twice as fast as the 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 your 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 the baby's stomach and also decrease reflux because there's 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 your bby. Burping will release gas and relieve the symptoms of reflux.

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 a baby's tummy and make them 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.

Medical Treatment for Baby 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 the 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."

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