asian father carrying his baby

Baby Reflux

About reflux

This is common in babies, due to an immature or weak muscle between the baby’s stomach and oesophagus. This allows the milk to escape from the stomach and flow back up, sometimes bringing stomach acids with it. There are several forms of reflux, ranging from mild (often called ‘posseting’) to severe (often called gastro-oesophageal reflux disease, or GORD).

When burping, hold your baby gently – don’t pat vigorously or bounce them up and down.

Young father playing with his daughter inside with toys

Posseting (vomiting small amounts of milk)

Posseting refers to bringing up milk after a feed. It’s annoying because it’s messy, and worrying because you wonder whether the baby’s getting enough nourishment. Posseting causes no pain or discomfort, and is no cause for concern if your baby is happy, feeds well and gains weight. It usually settles at around 6 months when your baby is sitting. If your baby is happy, alert and putting on weight, there is no need for medical intervention.

Reflux (gastro-oesophageal reflux disease, or GORD)

This more severe form of reflux can be similar to adult heartburn — discomfort or a burning sensation due to stomach acids leaking back into the baby’s sensitive oesophagus, along with the milk, causing inflammation. The condition can be difficult to diagnose, especially in cases where the milk does not come out of the baby’s mouth (as it does in posseting). Sometimes milk or stomach acid is only regurgitated as far as the oesophagus or throat (called ‘silent reflux’). This still causes the baby discomfort and there is usually disruption to feeding and possibly sleeping patterns. Babies may cry during or shortly after a feed, pull off the breast, arch their back, become rigid, writhe, kick or throw out their arms. They are not happy babies.

Managing posseting and mild reflux

  • Change your baby’s nappy before a feed rather than after.
  • Lay a pillow or folded towel under their head and shoulders on the change table.
  • Wipe their bottom by turning them on their side, rather than pulling their legs up to the tummy (which puts pressure on the baby’s stomach and forces milk and acid into the oesophagus).
  • Give your baby tummy time on the floor before feeding, rather than after.
  • While feeding, hold your baby in a more upright position.
  • When burping, hold your baby gently – don’t pat vigorously or bounce them up and down.
  • After feeding, sit them semi-upright in a baby chair or rocker, or carry them in a pouch for 15 minutes, to help settle the milk.
  • Some parents find that elevating the head end of the cot helps

Posseting causes no pain or discomfort, and is no cause for concern if your baby is happy, feeds well and gains weight.

Tips

  • During floor play, lay your baby on an absorbent quilt, which can be machine washed.
  • Put towels on the floor around you when feeding.
  • Choose bibs with elastic around the neck, or Velcro fasteners, which are easy to take on and off. Make sure the bib is wide enough to cover the shoulders, and extends around the back of the neck, to catch those unexpected possets.
Senior woman getting out of bed holding lower back in pain

When to seek help

  • If there is blood or bile (yellowish fluid) in baby’s vomit.
  • If there is blood in baby’s bowel motions.
  • If they have severe vomiting or projectile vomiting.
  • If they are losing weight or have poor weight gain.
  • If they refuse to feed.
  • If they find it difficult to swallow or choke easily.
  • If they have a recurrent cough.
  • If they are persistently unsettled and crying.
Young father playing with his daughter inside with toys

Possible medical treatment

  • Tests to show if reflux is occurring.
  • Medication – either to help empty the stomach more quickly or to reduce acid production by the stomach.
  • A powder to mix with your breastmilk or formula, to thicken it and help keep down the milk.
  • If it’s severe, or there is no improvement, and/or your baby remains distressed or is not gaining weight, ask your doctor to refer you to a paediatric gastroenterologist.

Support organisations

For more information you can visit websites such as the Reflux Infants Support Association (RISA), formerly the Vomiting Infants Support Association (VISA): www.reflux.org.au

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