It's lovely to see a happy baby guzzling down a feed – but terribly distressing and depressing when those feeds frequently seem to cause squeals of pain, before being brought back up again in their entirety. If your baby is vomiting large amounts, several times a day, they might be suffering from reflux.
What is it?
Reflux or gastro-oesophageal reflux (GOR) refers to a condition whereby the contents of the stomach (food and acid) rises back up into the oesophagus or mouth. Adults can get it too but, in little ones, it's caused by the valve at the top of the stomach being too immature to hold the food down.
Reflux can be mild with just occasional possetting (bringing up a little milk), and that is common and no cause for concern. But if your baby is struggling to keep milk down after the majority of feeds, and seems to find feeding painful (you might notice back arching and squirming), this may be what is known as gastro-oesophegal reflux disease (GORD).
It's most common in younger babies and the likelihood of GORD decreases as children get older (most will be clear of it by the age of 12 months, although occasionally it can carry on into toddlerhood (see below).
Both bottle and breastfed babies can get it and giveaway symptoms could include frequent hiccuping, plus excessive crying, coughing and not wanting to be put down after feeding. Your baby might also struggle to gain weight.
What can I do?
If you suspect GORD, go to your GP who will probably be able to give you a diagnosis based on what you tell them (occasionally there may be the need for further tests, for example to investigate the amount of acid in the oesophagus.)
Your doctor might prescribe a thickening agent to add to your baby's milk, which will help to keep it down, and also possibly an infant antacid, to reduce the heartburn they are experiencing. Both can be really effective, but should be given under the ongoing supervision of your GP.
If your baby's reflux is mild but irritating, there are certain things you can do to help them while it sorts itself out (use these tips for GORD babies, too).
Try burping your baby more frequently during their feed to get excess air out before their tummy is full and prone to 'overflow'.
Hold them upright for 15 or 20 minutes after their feed – lying down straight afterwards might bring on the hiccups and vomiting.
For night time feeds, when you really don't want to hold them (or yourself!) upright, you could try a reflux wedge – a wedge-shaped piece of foam that props them up slightly in their crib.
If none of that seems to help, if you are still worried about your baby's weight gain, or you notice other symptoms – such as blood in your baby's poo – then go back to your GP who might suggest a referral to a paediatrician.
What else could it be?
If your baby is crying regularly, with squirming and back arching, but only at one particular time of the day, they might have colic.
The symptoms of reflux are similar to lactose intolerance and allergy.
Little Refluxers offers help and support to parents with reflux babies.
REFLUX IN TODDLERS/CHILDREN
What is it?
Although mostly experienced by young babies, occasionally reflux or gastro-oesophageal reflux disease (GORD, see above for more details) can occur in toddlers, and even more rarely in older children. It will, in most cases, have gone by the age of two.
Of course, before a certain age, young children don't have the language skills to explain to you what's going on. It's not unusual for toddlers to be picky about their food, but if yours is demonstrating strange behaviour, such as signalling to you that they are hungry but then not eating, or crying inconsolably after their meal, reflux might be the culprit.
Other giveaway signs might include slow weight gain, wet sounding burps, vomiting yellow liquid, coughing, a hoarse voice, and sleep issues – because the acid in the stomach is more likely to rise up into the oesophagus when lying down.
What can I do?
If you suspect GORD, go to your GP who will advise on the best course of action according to their age and particular symptoms.
They might suggest that you give your child smaller, more frequent meals, make sure they chew everything well and avoid substances that might aggravate the condition, such as fizzy and caffeinated drinks, chocolate, spices and acidic foods (citrus fruit and tomatoes for example). Raising the head of their bed on blocks might help at night time.
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