April 04, 2013 6 min read

A baby in distress brings out a natural instinct to do whatever it takes to ease their discomfort. If your little one is crying and spitting up excessively, it’s no surprise that you’re worried about their well-being. But every baby spits up or vomits from time to time. For some, it occurs often and even with every feeding. 


However, you most likely have nothing to fear. Everything in an infant, from their brain to their gastrointestinal tract, is in the process of developing—once their gastrointestinal tract fully develops, the problems with acid reflux will likely fade away. While it’s common for every baby to spit up or vomit every once in a while, it’s unlikely that these issues will persist for very long.


Many doctors agree that infant acid reflux usually resolves itself eventually. But, in the meantime, there are steps you can take to help soothe a fussy, uncomfortable baby. So, to get a better understanding of infant acid reflux and what causes it, we’ll take a look at the following:

  1. What is Infant Acid Reflux? 
  2. Symptoms of Acid Reflux in Infants 
  3. Causes of Acid Reflux in Babies 
  4. Treatment Options for Babies with Acid Reflux 

What is Infant Acid Reflux?


Infant reflux, or gastroesophageal reflux (GERD) as it’s sometimes called, is when food comes back up from a baby’s stomach, causing them to spit up or vomit. If you’ve spent time with a baby, then you’re probably aware that spitting up isn’t unusual in and of itself. Every baby experiences it at some point, and it’s usually not a cause for concern. 


Acid reflux typically becomes less common as the baby gets older. It’s uncommon for acid reflux symptoms to persist after 18 months—in this case, it would be wise to seek out professional medical advice. While infant acid reflux usually isn’t anything to worry about, it can occasionally indicate a more serious condition, such as an issue with the baby’s digestive tract or an allergic reaction of some kind. It may even be a sign of gastroesophageal reflux disease (GERD), a digestive disorder that causes recurring acid reflux. 


Symptoms of Acid Reflux in Infants 

Acid reflux presents itself in a number of ways with infants. While adults experiencing acid reflux can effectively communicate their feelings of discomfort, like describing heartburn or a sour taste in the back of their throat, babies can’t do the same. This means that you’ll need to keep an eye out for outward symptoms and pay close attention to what causes acid reflux flare ups for your baby. 


According to medlineplus.gov, some of the most common symptoms of acid reflux in infants include: 

  1. Frequent vomiting 
  2. Colic (crying that inexplicably lasts for more than three hours per day) 
  3. A chronic cough 
  4. A reluctance to eat 
  5. Arching of the back during or after feeding 
  6. Choking or gagging during feeding 
  7. Frequent crying or irritation following feeding 

While these symptoms may indicate moderate acid reflux in your baby and shouldn’t cause you too much worry, there are other, more serious symptoms you should watch out for as well. Contact a doctor as soon as possible if your baby:

  1. Regularly projectile vomits 
  2. Produces an unusual amount of vomit 
  3. Throws up fluid that is yellow, green, coffee ground-colored, or bloody
  4. Has trouble breathing after vomiting 
  5. Shows signs of dehydration 

baby with acid reflux at checkup

Causes of Acid Reflux in Babies 

The lower esophageal sphincter (LES) is a clump of muscles separating your esophagus from your stomach. The LES acts as a valve that opens to allow food into the stomach and then, under normal circumstances, closes to prevent the stomach’s acidic contents from escaping. 


The reason infants are so prone to spitting up is because their LES has not yet fully matured, meaning it often doesn’t close all the way. When the LES doesn’t close up entirely, the infant’s stomach contents are able to bypass the valve and seep into the esophagus. 

 

infant acid reflux infographic


Some other factors that can contribute to infant acid reflux include:

  • A liquid-based diet 
  • Complications from premature births 
  • Regularly keeping your baby flat on their stomach 

To resolve some of your infant’s acid reflux symptoms, you might try feeding them a diet that consists of various textures. And, if you’re asking yourself, “Is it bad to sleep on your stomach?” the answer is usually yes, especially for infants. Newborns should be placed flat on their back in order to minimize the risk of sudden infant death syndrome (SIDS).


Treatment Options for Babies with Acid Reflux 

When dealing with acid reflux, an infant’s course of treatment should be determined according to a couple of factors. First, the most effective type of treatment likely depends on the severity of the condition—oftentimes, infant acid reflux can be solved using home remedies, without having to give the baby any medication or have them undergo any invasive medical procedures. 


How you treat the infant’s acid reflux also depends on how long they’ve been experiencing symptoms for. If the baby is under a year old and has only been experiencing symptoms for a few months, then minor changes can often help provide relief. 


It’s always best to consult with your pediatrician about the best course of treatment, but here’s a summary of some of the options they may recommend to you. 


Home remedies 

Many parents turn to home remedies in order to deal with their baby’s acid reflux. That’s because making changes in how you feed your baby is often the most natural, cost-effective, and easiest way to reduce symptoms. While adults suffering from acid reflux may find relief by using products like MedCline’s Reflux Relief System, you may need to take a different approach with babies. 

 

natural treatment for infant reflux infographic


Here are five simple methods that can potentially help relieve your baby’s acid reflux symptoms:

  1. Try smaller, more frequent feedings
  2. Take a break during feedings to burp your baby and always burp after feeding
  3. Hold your baby upright during feedings and for 30 minutes afterwards
  4. Try incorporating rice cereal into your baby’s diet 
  5. If you’re bottle-feeding, make sure to keep the nipple filled with milk to minimize the amount of air your baby swallows

 

Medication

You should generally only use medication to treat your baby’s acid reflux symptoms if your pediatrician advises you to do so. They can be effective in certain cases to treat particularly bad acid reflux—for example, if the home remedies haven’t worked, the baby won’t eat, or their esophagus shows evidence of inflammation—but giving your baby medication typically isn’t the first path you should go down. 


While acid reflux medicines like proton pump inhibitors (PPIs), H2 blockers, and antacids, are commonly used by adults, they are usually not as successful in reducing the symptoms of acid reflux in infants. Not only can these drugs be ineffective, they can also potentially increase the risk of some intestinal and respiratory infections and, in the long-term, can interfere with the baby’s ability to absorb iron and calcium.


Surgery

Surgery on an infant’s gastrointestinal tract is only necessary under very rare circumstances. A surgical procedure is often a last resort that parents turn to when the acid reflux condition is so severe that it has interfered with the baby’s ability to grow or breathe. When both home remedies and medication are unable to relieve a baby’s acid reflux symptoms, then surgery may be the only option left. 


The surgery that the infant would undergo in this case is called a fundoplication. The main goal of the surgeon conducting the operation would be to tighten the LES so that stomach acid could no longer escape and irritate the baby’s esophagus. Keep in mind that, even after surgery, it’s still a good idea to try out home remedies in order to minimize symptoms in the long-term. 


Summary

It’s important for parents to know that spitting up and vomiting in babies are common problems that often get resolved with time. But as long as your baby is content and gaining weight at a normal pace, there’s generally no need for concern. That’s because, for most babies, acid reflux will eventually naturally subside. 


Typically, the LES tightens during the first year, around four to five months of age, and the constant spitting up goes away. But if your baby is still experiencing recurring acid reflux at 18 months, then it’s probably a good idea to schedule an appointment with your pediatrician to see whether it’s indicative of a more serious condition, such as GERD.


References:

  • “Fundoplication (Pediatric).” UCSF Department of Surgery, University of California San Francisco, 2020, surgery.ucsf.edu/conditions--procedures/fundoplication-(pediatric).aspx. 
  • “GERD (Gastroesophageal Reflux Disease) in Children.” Johns Hopkins Medicine, The Johns Hopkins University, 2020, www.hopkinsmedicine.org/health/conditions-and-diseases/gerd-gastroesophageal-reflux-disease-in-children. 
  • “Reflux in Infants.” MedlinePlus, U.S. National Library of Medicine, 23 Sept. 2020, medlineplus.gov/refluxininfants.html. 
  • “Symptoms & Causes of GER & GERD in Infants.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Apr. 2015, www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants/symptoms-causes.