Everything you need to know about infant reflux

Puke-a-sarus: (n) an incredibly cute infant with gastroesophageal reflux that vomits regularly with every feeding. 

Theo was given that nickname by his papa when he was just a little baby because he suffered from severe reflux. At just 5 weeks old, he vomited with every feeding. It was much more than just a little spit up; it was projectile vomiting at times. 

His reflux was so severe that he had poor gain weight for a few weeks. Our pediatrician was so concerned that she sent us to the hospital for an ultrasound to rule out pyloric stenosis (obstruction in his abdomen). Luckily, the results were normal and within 6 months, the reflux resolved on its own. 

Levi is almost 8 weeks old today and just like his big brother, he started vomiting with every meal at 6 weeks old. He can easily regurgitate 4-6 times a day during and after his meals. His symptoms are much less severe than Theo’s, but it is annoying for this mama! 

These days you’ll find me covered in spit up. I go through multiple burp rags and outfit changes daily for the both of us! Sadly, 3 loads of laundry every few days has become a norm around here! 

Both my babies have GER aka bad reflux. This is very common in infancy and usually is not concerning. 

Since this is my second time around with a reflux baby, I'm confident in treating him without rushing him to the doctors. 

Infants typically spit up within 1-2 hours after feeding. Reflux occurs usually within the first 1-2 months of life and peaks around 3-4 months. Most infant’s reflux improve within 6-8 months and resolve completely by 18 months. 

Most common causes of infant reflux:

  • Forceful let down during breastfeeding or oversupply
  • Food sensitivities (most common is cow’s milk and soy protein)
  • Typical symptoms of GER includes:
  • Vomiting or spitting up
  • Refusal to eat and difficulty eating or swallowing
  • Irritability during feeding
  • Gagging or choking sensation

Some tips to minimize reflux in an infant: 

  • Feed your baby in an upright position
  • Feed smaller and more frequent meals
  • Stop to burp your baby during and after feedings
  • Avoid laying your baby down in a flat position for 30 mins after feeding
  • Avoid laying your baby down on his abdomen (tummy time) for at least 30 mins after feeding
  • Continue breastfeeding
  • Avoid smoke or tobacco exposure
  • Limit cow’s milk or soy protein intake
  • Eliminate or reduce caffeine intake
  • Feed your baby when he is calm to reduce anxiety
Pro tip: use the largest burp rag known to man to catch all the incoming vomit

Symptoms of GER are usually mild and self-limiting. Do not confuse GER with GERD (which is a much more severe reflux symptom that warrants more medical intervention). Infants with GERD should visit their pediatrician for further evaluation. 

Some warning signs include:

  • Poor weight gain
  • Forceful vomiting
  • Vomiting blood
  • Rectal bleeding
  • Sudden onset of vomiting after 6 months  of life
  • Hard mass on abdomen
  • Severe fussiness associate with feedings
  • Difficulties breathing (wheezing, chronic cough)

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