Reflux happens when some stomach contents (eg breastmilk) pass from the stomach back up into a baby’s oesophagus (muscular tube that leads from the mouth to the stomach), and sometimes spills out her mouth. This spilling, which can be called spitting up, posseting or bringing milk up, is common in babies, especially after a feed. Reflux occurs in adults too, but we’re mostly not aware of it. Babies spend a lot of time lying down, have a liquid diet and a short oesophagus. These factors make reflux more noticeable.
Reflux is equally common in formula-fed and breastfed babies, but formula-fed infants have episodes of reflux more often than breastfed babies and they last longer.
Simple reflux
If a baby with reflux is otherwise happy and putting on weight well, this is called ‘simple reflux’. It doesn’t hurt the baby and it usually stops by itself as the baby grows.
Reflux disease
There is also ‘reflux disease’ which is a medical problem and requires medical advice.
The following symptoms may indicate reflux disease, which needs medical advice:
- Your baby is bringing up a large amount of milk after most feeds.
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She seems to be in pain after breastfeeds.
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She is fussy and unhappy between feeds.
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She arches her back after most feeds.
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She has problems gaining weight.
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Ongoing breathing (respiratory) problems.
It often helps to feed a baby with reflux in a more upright position than is usual. You may need to experiment with different positions. Some mothers sit their baby facing the breast, astride mum's leg or cuddle them against the side of the sofa, facing the breast. Others have found that instead of cradling their baby around their body, they can cradle the baby down the body. To do this, some mothers feed twin-style, while others feed standing up; or you can recline so that your baby lies on top of your body. After a feed, keep baby upright and still. Many mums find putting baby on their shoulder keeps him happier.
Some babies do better with smaller, more frequent feeds. This causes less pressure on the sphincter muscle between the oesophagus and the stomach. They may not want both breasts at each feed, or may do better if offered only one side, but more often.
However, as reflux episodes are worse in the first hour or so after feeds, some babies may prefer a larger feed less often. These babies may feed from both breasts at each feed, and go longer between feeds. You may like to experiment to see what helps your baby.
