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Treating Acid Reflux in Infants

Overview

Highlights

  1. An infant with acid reflux may refuse to eat, have trouble gaining weight, or cry uncontrollably.
  2. Bottle-fed babies may have less acid reflux with a modified feeding schedule.
  3. Although surgery can help, it’s typically reserved for babies whose reflux causes severe breathing problems or prevents growth.

Acid reflux, also known as gastroesophageal reflux (GER) is the backing up of stomach contents into the throat. It isn’t just an adult illness. Infants can experience it, too. You may be concerned if your child doesn’t want to eat, doesn’t gain weight, or doesn’t stop crying. Acid reflux in an infant may sound scary, but a confirmed diagnosis can help with management.

The ways to treat acid reflux in your infant depends on your baby’s age and the severity of the problem. Lifestyle changes and simple home care are often all that is needed.

Learn more: Causes of acid reflux in infants »

How and when to feed your baby

Give more frequent feedings

Your baby may be more likely to reflux and spit up when their stomach is too full. Bottle-fed babies may have less acid reflux with a modified feeding schedule. Instead of a few larger meals, feed your infant more frequently throughout the day so they eat less at each feeding.

A less-full stomach puts less pressure on the lower esophageal sphincter (LES). The LES is the ring of muscle that blocks food from going back into the esophagus from the stomach. Pressure on this muscle causes it to lose effectiveness, allowing stomach contents to rise into the throat. LES strength takes time to develop over the first year, so many infants naturally spit up often.

Feeding on demand whenever your baby appears to be hungry may also be helpful.

Check bottle and nipple size

If you bottle feed, your infant may gulp air while eating if the nipple on the bottle is too small. However, the milk will flow too fast if the nipple is too large. Using a proper sized bottle and nipple allows the right amount of milk to flow without allowing your baby to swallow air at the same time.

Thicken breast milk or formula

With your pediatrician’s approval, adding a small amount of rice cereal to formula or breast milk may help lessen visible spitting up, but has not been shown to decrease other reflux symptoms. Thickening the food is thought to help stop stomach contents from sloshing up into the esophagus.

Burp them more often

Whether you bottle-feed or breast-feed, avoid feeding your older infant two hours before bedtime so you can burp them. Burping your infant every one to two hours after feeding may help relieve gastric pressure and therefore help prevent acid reflux. Burp your bottle-fed infants after every one to two ounces during feedings. And for breast-fed babies, you should burp them any time they pull off the nipple.

Your infant’s sleeping position

When your baby's upper body is elevated, gravity helps keep the contents of the stomach from going back into the esophagus.

Place your baby in the crib on a firm mattress, with their head turned to the side so that their mouth and nose aren’t obstructed. Elevate your baby’s head by placing the mattress on a slight incline to relieve acid reflux. A foam block placed under the head of the mattress works well, as does a wedge pillow.

Gripe water: Is it safe?

Although parents sometimes try gripe water to ease symptoms of reflux, there’s no scientific evidence of its effectiveness. Ingredients vary depending on the manufacturer, but many versions of gripe water include fennel, ginger, peppermint, lemon balm, and chamomile. The World Health Organization says that giving anything other than breast milk to infants younger than 6 months may increase the risk of bacterial infection, allergies, and stomach irritation.

Speak to your baby’s pediatrician if you’re interested in using natural remedies to treat your child’s reflux. You should get their approval before giving your baby gripe water. If they give you the go-ahead, avoid products that contain sodium bicarbonate, sucrose, fructose, or alcohol.

Medication and surgery

If lifestyle changes don’t help, your pediatrician may want to treat your infant's acid reflux with medication. They may recommend H2 blockers, such as cimetidine (Tagamet) or ranitidine (Zantac). These drugs reduce the amount of acid in the stomach. They also carry several risks, including an increased risk of community-acquired pneumonia. Be sure to discuss any risks with the doctor. The doctor may advise a short two-week trial of the drugs for symptoms that have not improved with other treatments.

Surgery may be an option if medications and lifestyle adjustments don’t help ease your baby’s symptoms and your baby isn’t gaining weight. Tightening the LES makes it more stable so that less acid flows back into the esophagus. The need for this type of surgery is rare, especially in infants. The procedure, called fundoplication, is usually reserved for babies whose reflux causes severe breathing problems or prevents growth.

The bottom line

Acid reflux in an infant is a treatable condition. Finding the lifestyle changes or medications that work for your child will help get their acid reflux under control. In many cases, simple adjustments at home may be all that’s needed to make your infant more comfortable. Talk to your doctor about your concerns, and they can help you find the best method for reducing your baby’s reflux.

Q&A

You asked, we answered

  • What if lifestyle changes or natural treatments don't help my infant’s acid reflux?
  • Simple, low-risk things you can try to lessen symptoms of acid reflux include more frequent burping, smaller meals, and propping the head of your baby’s crib mattress. But don’t be surprised if these do not help; the only proven treatment for acid reflux in an otherwise healthy baby is time. If your baby has more serious symptoms, such as poor weight gain or significant vomiting, talk to your doctor about other potential causes or treatments.

    - Healthline Medical Team
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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