BY CARA SUTTNER
It’s true! Despite its pathological connotation, most of our young babies will reflux their milk. Reflux simply means “the flowing back of a liquid”, and because our babies survive on a low density liquid diet and have immature muscles on their oesophagus, paired with tiny tummies, any milk that sits at the top of their stomachs will easily “flow back”.
We see this as small (or not so small) vomits, possets or spit up after a feed. Or, if the milk only reaches the oesophagus/ back of the throat and is then re-swallowed, we may not see anything at all (also known as “silent reflux”).
Since we, as adults associate vomiting with being unwell, seeing our precious bubs vomiting after a feed can be very distressing. However, in the vast majority of cases reflux is not a medical problem, only a laundry problem! If your baby is, what we call a “happy spitter” ie they vomit and don’t get too upset by it, putting on weight and feeding happily then reflux is no more than an annoying mess. Be aware that often the amount of spit up looks a lot larger than it is. To illustrate this, I often get mums to measure up 5mL of water and throw it against their shirt. This small measurement of liquid can soak your shirt where it lands, but is not enough to cause a baby to dehydrate. In most cases, babies will vomit because they took in excess milk, and it’s their bodies way of getting rid of it. Therefore there is usually no need to top baby up after they reflux (unless of course there are other hunger cues).
Reflux however can be a problem if it is associated with pain, distress, weight loss and a baby who refuses to eat. In these cases reflux is the cause of what is called GORD (gastro-oesophageal reflux disease) and these cases need to be assessed and treated by your doctor . This can happen because the milk and gastric juices are acidic and if reflux is exacerbated, can cause irritation and inflammation of the oesophagus.
It is hard to definitively diagnose these cases as diagnostic tests are quite invasive. So in most instances, if you, or your health professional suspect GORD; they will trial your baby on some medication to see if this alleviates the symptoms. These medications are called antacids, and work by reducing the amount of acid made by the stomach. So while your baby will still probably reflux, it will no longer hurt as much, or cause as much irritation. These medications are dosed according to weight, so as your baby grows it is important to update your prescription.
When typical reflux treatments aren’t working it may be worth considering if other things are upsetting your baby. The most common things I see that are associated with feedings are :
-Baby is getting too much milk/ milk is flowing too quickly
-Baby is not getting enough milk/ milk is slow flowing
Both of these things can irritate bub, and can present with reflux, crying, back arching and food refusal.
The good news is, that as babies and their tummies grow, their bodies mature and we start introducing more dense solids into their diets; reflux and GORD too, will pass. In the meantime- look out for those specials on laundry detergent!
Cara Suttner is a Neo Natal Nurse, certified Lactation Consultant (IBCLC) and mother of Five, find out more about her HERE