When It Comes To Infant Acid Reflux, Take The Road Less Traveled To Relief

A baby in distress yields a natural instinct to do whatever it takes to ease the discomfort. If your little one is crying excessively and spitting up, it’s tempting to want a quick fix to relieve the suffering. However, in many cases, turning to acid-blocking medications is a road that leads to nowhere, except for possibly other complications. You’re better off taking a different route to help your baby find relief.

While anti-reflux medications, like Proton-Pump-Inhibitors (PPIs), H2 Blockers & antacids, are commonly used by adults, they are unsuccessful in reducing the symptoms of acid reflux in infants. Not only are these drugs ineffective, they are potentially harmful to children as they drive an increased risk of some intestinal and respiratory infections and, over the long-term, can lead to problems with absorption of iron and calcium.

Yet, between 1999 and 2004, prescription medications to treat GERD (Gastroesophageal Reflux Disease) in infants increased 700 percent. A recent study, with lead author Laura Scherer, an assistant professor in the department of psychological sciences at the University of Missouri, reports that when physicians put a GERD label on typical symptoms in infants – such as crying and spitting up – parents are more interested in medication for their baby, even when they’re made aware of the likely ineffective outcome.

It’s important for parents to know that spitting up and vomiting in babies are common problems that often resolve in time. As long as your baby is healthy, content and gaining weight at a normal pace, there’s no need for concern.

“Roughly 50 percent of babies during the first six months are spitting up enough to bother their parents,” said Dr. William Carey, an attending physician at The Children’s Hospital of Philadelphia, who wrote a commentary published with the study. “I never offered medication for a kid who was just spitting up and gaining weight well and happy,” he told Reuters Health. “I could confidently tell the mother, ‘Look, it’s going to be a nuisance until about six months, and then it’s gradually going to get better.’ It’s an irritating variation of normal.”

However, there are some simple methods that can help your baby:

  • try smaller, more frequent feedings
  • take a break during feedings to burp your baby and always burp after feeding
  • hold your baby upright during feedings and for 30 minutes afterwards
  • avoid wiggling or jostling your baby while you’re feeding and while the food is settling

Another consideration is that reflux can be caused by an allergy to a protein in cow’s milk. If you’re breast-feeding, your may try removing dairy products or beef from your diet. If you’re using baby formula, sometimes changing to a different type can help.

For most babies, reflux will eventually subside. Typically, the lower esophagus valve tightens during the first year, generally around 4-5 months of age, and the spitting up goes away. But there are some situations when you should be more concerned and contact your pediatrician: 

  • if your baby isn’t gaining weight
  • if your baby is projectile vomiting rather than spitting up
  • if the spit up is a green or yellow fluid, has blood or a material that looks like coffee grounds
  • if there is no desire for food
  • if there is blood in the stool
  • if your baby has difficulty breathing
  • if vomiting begins at age 6 months or older

Every baby spits up or vomits from time to time. For some, it occurs often and even with every feeding. Many doctors agree that these behaviors usually resolve on their own and anti-reflux medications are not the best path to take. In the mean time, you can help soothe a fussy, uncomfortable baby with some small changes to your feeding technique.

References:

1. Scherer, Laura D. PhD, Zikmund-Fisher, Brian J. PhD, Fagerlin, Angela PhD, and Tarini, Beth A. MD, “Influence of “GERD” Label on Parents’ Decision to Medicate Infants”. Pediatrics doi: 10.1542/peds.2012-3070. April 1, 2013.

2. American Board of Internal Medicine Foundation. “Leading Medical Specialty Societies Identify 90 Tests and Treatments to Question”. http://www.abimfoundation.org/News/ABIM-Foundation... February 21, 2013.

3. Wall, Timothy. “Disease Over-Diagnosis Can Result in Needlessly Medicating Infants, Finds MU Research” News Bureau University of Missouri. http://munews.missouri.edu/news-releases/2013/040... finds-mu-research/ April 2, 2013.

4. Mayo Clinic Staff. “Infant reflux”. Mayo Clinic. http://www.mayoclinic.com/health/infant-acid-refl... March 28, 2013.

5. WebMD. “Spitting Up and Vomiting in Babies”. WebMD. http://www.cbsnews.com/8301-204_162-57577311/rece... diagnosis-may-make-a-parent-more-likely-to-want-unnecessary-medication/. December 21, 2010.

6. Castello, Michelle. “Receiving ‘disease’ diagnosis may make a parent more likely to want unnecessary medication.” CBS NEWS. http://www.cbsnews.com/8301-204_162-57577311/recei... medication/. April 1, 2013.