Pediatrics Corner

Pediatrics Corner

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Reflux in infants

Reflux in a baby occurs when the contents of the stomach are spit out, usually shortly after feeding.  It is more common in the young infant and often improves over time.  Symptoms arise from the region known as the lower esophageal sphincter (LES), a muscular area between the esophagus and the stomach which may not be full developed and thus food is able to flow backward.  As the baby grows the LES stays closed and food will not move in a reverse direction.


Symptoms of spitting up often improve once the baby is able to tolerate solids, between 6-12 months.  Reflux may be observed in smaller amounts, referred to as "wet burps" and does not cause the baby any discomfort.  To tell the difference between vomiting and wet burps you should observe if your baby appears ill. Symptoms that are accompanied with diarrhea or have a sudden onset, all suggest vomiting.  Reflux dose not involve lethargy, fever, bilious vomiting, or blood in the vomit.


Sometimes referred to as the "happy spitter", you can expect that your baby is doing well even though he or she may have reflux if, the baby has good weight gain, appears to have a normal eating pattern, and is not acting more irritable than is normal.


Simple steps to help your baby with his/her reflux include the following:

1) provide a smoke free environment.

2) Avoid overfeeding, since stretching the stomach leads to more food coming back up the esophagus.

3) Avoid increased gassiness by burping the baby often.

4) During bottle feeding, keep the nipple full of milk, and thus prevent the baby from swallowing air while sucking on the nipple.

5) Keep your baby in an upright position for at least 20 minutes after feeding. This does not include keeping your baby in a semi-upright position as the may actually make symptoms worse.


When should you contact your doctor?

1) If the baby is having large amounts of spit up.

2) If a spit up/vomit seems foreful.

3) If you have any concerns about weight gain.

4) If your baby has started having fewer wet diapers.

5) If the baby seems lethargic, fussy, feverish, or appears to be in pain.

6) Spit up is green, brown, or contains blood.


Margaret Fritts, FNPC