Reflux in Babies
It seems that every baby at some time has experienced reflux. And while most of us have an idea of what reflux is, the specifics can still be a little confusing.
Like most baby related conditions it can help to understand the reasons for our baby’s behaviour so we can care for them in the best possible way.
What Exactly is Reflux?
Reflux is the shortened term for Gastro-oesophageal reflux, or GOR. Because babies are small and their digestive system is immature, milk can easily pass from their stomach back up into their oesophagus (food pipe). The oesophagus is the tube which connects the mouth to the stomach.
Another cause for reflux is when the sphincter, or muscle at the bottom of the oesophagus relaxes and allows milk to flow back out of the stomach. Ideally, the sphincter opens to let milk into the stomach and then closes to keep milk in. When the sphincter relaxes for too long, or it’s immature, acidic milk flows back into the oesophagus. This can cause heartburn, vomiting and nausea. Sometimes the milk goes into the trachea (windpipe) which causes coughing or infection.
With time and gut maturity, most babies outgrow reflux and have no long lasting digestive problems because of it.
What Causes Reflux?
A baby’s gut is immature. Just like the rest of their body, growth over time increases the size of their stomach and the way their body functions. The muscles involved in keeping milk down and within the stomach can be lax and the sphincter at the top of the baby’s stomach more open than it could be. This combination of muscle relaxation and an open inlet means that milk easily refluxes back up into baby’s oesophagus. The shortness of a baby’s oesophagus and distance between their mouth and their stomach means that reflux is common.
First, the Basics
Milk begins its digestion in the mouth and then, when it reaches the stomach, enzymes and acid are released to help break it down. The lining of the stomach is designed to withstand the effects of acid; however, the oesophagus is not. As the milk rises up into the oesophagus it can cause pain.
Some babies seem to bring up milk as effortlessly as they smile. Without any warning, milk comes out of their mouth as easily as it flowed in. On a spectrum of reflux-related symptoms, these babies are the easiest to manage. The most difficult aspect to their care is making sure there’s always an absorbent towel or cloth close by during, between and after they’ve fed.
Other babies show some distress when they reflux. There can be discomfort or pain as the milk regurgitates from their stomach into their oesophagus. This may also be influenced by uncomfortable gut sensations which cause the baby to feel insecure. This is one reason why soothing and reassurance from parents can make a big difference to babies who are experiencing reflux symptoms.
What’s important is that as long as the baby is still mostly happy and continues to gain weight, there is no value in treating their reflux or doing anything special.
When Do I Need to Be Concerned About My Baby’s Reflux?
It’s estimated that around 70-85% of babies experience regurgitation within their first two months of life. This resolves, without intervention, in around 95% of babies by the time of their first birthday.
It is true that over this time span, some babies do need more active treatment for their reflux, especially when it is impacting on their growth and general health. Changes in position, holding them upright after feeds, gentle handling and comforting can all make a big difference.
Sometimes changes in feeding are recommended, especially if the baby is also showing signs of sensitivity to specific milk proteins. Where necessary, medications may also be prescribed to help reduce the symptoms of discomfort and improve the way milk is digested within the stomach.
Always speak and check with a qualified nurse or healthcare professional about your baby to understand what your baby’s individual needs are, especially if you are ever concerned about your baby's well being.