Treat Acid Reflux in Newborns

Many newborns experience acid reflux, which is when food backs up from her stomach and causes your baby to spit up. Acid reflux, also called gastroesophageal reflux disease (GERD), is generally not serious and often stops by 18 months old; however, seeing your newborn experience discomfort from acid reflux can concern or upset you. By making some lifestyle changes or using medication, you can treat your newborn’s acid reflux.

Steps

Making Lifestyle Changes

1. Recognize symptoms of acid reflux. Watch your baby to see if she exhibits symptoms of acid reflux before making lifestyle changes. Typical signs of acid reflux in newborns are:
   • Spitting up and vomiting
   • Refusing to eat
   • Having difficulty eating or swallowing
   • Being irritable during feedings
   • Burping or hiccuping wet liquid
   • Failing to gain weight.
2. Adapt bottle feedings. Try changing the ways you feed your baby with a bottle. These may help relieve or prevent acid reflux in your newborn.
   • Increase the frequency of your baby’s feedings but reduce how much you give him at each feeding so that there is less pressure on the muscle that keeps food from refluxing.
   • Make sure your baby’s bottle and nipple is the right size. This allows your baby to get the right amount of milk from the nipple without swallowing air.
   • Try a different brand of formula, but only after discussing it with your baby's doctor.
   • Thicken the formula with some rice cereal with your pediatrician’s approval and directions.
3. Modify breastfeeding techniques. Babies who are breastfed may experience slightly less reflux because breastmilk is digested faster than formula. Similar to bottle feeding, changing your breastfeeding technique may help treat your newborn’s reflux.
   • Reduce the amount of milk in your baby’s stomach by breastfeeding for less time each feeding, but more frequently throughout the day.
   • Eliminate different foods from your diet to see if this eases your newborns reflux. For example, you may want to avoid dairy, beef, or eggs to see one of these causes the reflux.
   • Thicken expressed breast milk with rice cereal in small increments.
4. Burp your baby more frequently. Interrupt your baby’s feedings to burp her. More frequent burping may relieve pressure in her belly and prevent reflux. Use the following schedule as a guideline for burping:
   • Avoid feedings two hours before bedtime if possible.
   • Burp your baby every one to two hours after a feeding to help relieve gas and prevent reflux.
   • Interrupt bottle feedings every one to two ounces.
   • Burp breastfed babies whenever they pull off of your nipple.
5. Hold your baby upright. Keeping your baby in an upright position can help relieve and prevent reflux because gravity keeps the contents of his stomach down. Make sure to keep him upright for 20–30 minutes after you feed him.
   • Place your baby on your lap with his head resting on your chest.
   • Try and keep your baby quiet while holding him upright.
6. Change her sleeping position. Doctors recommend that babies sleep on their backs to minimize the risk of sudden infant death syndrome; however, this position may cause problems for babies with moderate to severe reflux and your doctor may suggest putting your baby to sleep on her side or stomach, but this is rarely recommended.
   • Make sure to speak with your baby’s doctor before changing her sleeping position.
   • Place your baby in her crib on a firm mattress with no blankets, bumpers, or stuffed animals that might suffocate her. Gently turn her head to the side so that her mouth and nose aren’t obstructed.
   • Consider elevating the mattress slightly with a foam block or wedge pillow under the head of the mattress. Avoid using a pillow on the mattress, which could suffocate your baby. If you elevate the head of the bed, you can often continue to put your baby to bed on her back, which is usually the safest.
   • Put your baby on her left side, which keeps the stomach inlet higher than the outlet, and may help keep food down.
7. Consider natural remedies. There are natural products called “gripe water” that many people use to soothe reflux and colic. There is no scientific evidence that gripe water is effective, but try it after consulting with your doctor.
   • Be aware that the World Health Organization doesn’t recommend giving gripe water to babies under six months.
   • Make sure to speak to your doctor before giving your baby gripe water.
   • Look for products with fennel, peppermint, lemon balm, chamomile, or ginger.
   • Stay away from products with sodium bicarbonate, sucrose, fructose, or alcohol.

Getting Medical Treatment

1. Visit your pediatrician. If making lifestyle changes doesn’t ease your newborn’s reflux or his symptoms get worse, schedule and appointment with his pediatrician. You should also see your baby’s pediatrician if he has the following symptoms:
   • Inability to gain weight
   • Projectile vomiting
   • Vomit or spit up that is green or yellow
   • Vomit or spit up that contains blood or material that looks like coffee grounds
   • Refusal to eat
   • Stools that are bloody
   • Chronic cough or difficulty breathing
   • Irritability after eating
2. Get a diagnosis. Your baby’s pediatrician will examine her and ask you questions about her symptoms. Depending on her She also may recommend further testing to confirm a diagnosis of acid reflux. Your doctor may order one of the following tests:
   • Ultrasound
   • Blood or urine tests
   • Esophageal pH monitoring
   • X-rays
   • Upper endoscopy.
3. Give your baby medication. Depending on the outcome of your doctor’s visit and possible testing, your doctor may suggest lifestyle changes and/or prescribe medication. Be aware that reflux medications aren’t generally recommended for babies with uncomplicated reflux as they could rarely cause health problems or prevent nutrient absorption.
   • Follow your doctor’s dosing instructions. Most medications given to babies for reflux are dosed specifically for them.
   • Give your baby drugs to reduce the acid. She’ll likely get either a proton pump inhibitors (PPIs) such as omeprazole (Prilosec or Prevacid) or an H2 blockers like Tagamet or Zantac.
   • Avoid giving over-the-counter acid blocking drugs to your baby.
4. Tighten the esophageal sphincter with surgery. In very rare cases, some babies may need surgery to tighten the muscle that blocks food from coming back up. The procedure, called fundoplication, is generally only done on babies that have severe breathing problems with their reflux.

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