Treating Acid Reflux in Infants

Written by Tayla Holman and Erica Roth | Published on May 5, 2015
Medically Reviewed by George Krucik, MD on May 5, 2015

Overview

Acid reflux, the backing up of stomach contents into the throat, isn’t just an adult illness. Infants can experience this uncomfortable feeling too. Parents of babies with acid reflux may become concerned if their 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 remedies are often the first steps.

How and When to Feed Your Baby

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

More Frequent Feedings

If you breastfeed, cutting back on the amount of time you spend nursing can help prevent reflux. Your baby may be more likely to reflux and spit up when their stomach is too full. This is due to the pressure that’s put on the lower esophageal sphincter (LES). The LES is the ring of muscle that blocks food from going back up the esophagus from the stomach. Pressure on this muscle causes it to lose effectiveness, allowing stomach contents to rise into the throat.

Check Bottle and Nipple Size

Your infant may gulp air while eating if the nipple on the bottle is too small. However, the milk will flow too fast if it’s too large. Using the 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

Trying a different brand of formula may help reduce reflux too. If you’re a nursing mother, try eliminating certain foods such as dairy products from your diet, in case a food intolerance is causing reflux symptoms.

With your pediatrician’s approval, adding a small amount of rice cereal to formula or breast milk can help prevent acid reflux. Thickening the food helps to stop stomach contents from sloshing up into the esophagus.

More Frequent Burping

Whether you bottle-feed or breastfeed, avoid feeding your infant two hours before bedtime. Burping your infant every one to two hours after feeding helps relieve gastric pressure and may help prevent acid reflux. Burp bottle-fed infants often during feedings, about every one to two ounces. You should burp breastfed babies any time they pull off the nipple.

Change Your Infant’s Position

Experts recommend that infants sleep on their backs to prevent sudden infant death syndrome (SIDS). But this position may obstruct the airways for babies with acid reflux. Your doctor may suggest that you put your baby to sleep on their side or stomach instead.

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. Gravity helps keep the contents of the stomach from reverting back into the esophagus when your baby's upper body is elevated. 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?

Gripe water is a natural remedy often used to soothe colicky babies. Ingredients vary depending on the manufacturer, but many versions of gripe water include fennel, ginger, peppermint, lemon balm, and chamomile.

Although there’s no scientific evidence of its effectiveness, gripe water is sometimes used by parents to ease symptoms of reflux. The World Health Organization says that giving anything other than breast milk to infants under the age of 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 your doctor’s approval before giving your baby gripe water. Avoid products that contain sodium bicarbonate, sucrose, fructose, or alcohol if your doctor gives you the go-ahead.

Medication Options & Surgery

Your pediatrician may want to treat your infant's acid reflux with medication if lifestyle changes don’t help. These can include infant doses of proton pump inhibitors (PPIs), such as Prilosec or Prevacid, or H2 blockers such as Tagamet or Zantac. These drugs reduce the amount of acid that’s present in the stomach.

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

The Bottom Line

The last thing a new parent wants is to see their baby in discomfort. However, 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. 

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