Infant reflux (sometimes called infant acid reflux) is the condition where the contents of the stomach are spit out, usually shortly after feeding. Spitting up (infant reflux) becomes less common as a baby gets older, and it's unusual if it's still occurring after 18 months of age.
In a small number of cases, reflux can be a sign of a more serious problem, such as gastroesophageal reflux disease (GERD), an allergy or a blockage.
Spitting up and vomiting are the main symptoms of infant reflux. As long as your baby is healthy, content and growing well, the reflux is not a cause for concern. Your child will in all likelihood outgrow it.
While your baby may act fussy or seem to be uncomfortable, it is very unusual for the stomach contents to be acidic enough to irritate the esophagus or throat, as happens with acid reflux.
Contact your baby's doctor if your baby:
Some of these signs may indicate more-serious conditions, such as gastroesophageal reflux disease (GERD) or pyloric stenosis. In GERD, the reflux contains stomach acid which damages the lining of the esophagus. Pyloric stenosis is a rare condition in which a narrowed valve between the stomach and the small intestine keeps stomach contents from emptying into the small intestine.
Infant reflux is related to a number of factors, often in combination with one another.
In infants, the ring of muscle between the esophagus and the stomach — the lower esophageal sphincter (LES) — is not yet fully mature, allowing stomach contents to flow backward. Eventually, the LES will open only when baby swallows and will remain tightly closed the rest of the time, keeping stomach contents where they belong.
Babies are lying flat most of the time, which makes reflux more likely. Moreover, their diet is completely liquid, also favoring infant reflux. Sometimes air bubbles in the stomach may push liquids backward. In other cases, your baby may simply drink too much, too fast.
Although infant reflux most often occurs after a feeding, it can happen anytime your baby coughs, cries or strains.
In a small number of cases, the symptoms of infant reflux are caused by something else. Among the possibilities:
Diagnosis of infant reflux is typically based on your baby's symptoms and a physical exam. If your baby is healthy, growing as expected and seems content, then further testing usually isn't needed.
If your baby's doctor suspects a more serious problem, diagnostic tests could include:
Most cases of infant reflux clear up on their own without causing problems for your baby.
If the condition is not normal reflux, but is GERD or some other condition (much less common), the baby may show signs of poor growth or problems with breathing. Some research indicates that babies who have frequent episodes of spitting up may be more likely to develop gastroesophageal reflux disease during later childhood.
To minimize reflux, consider these tips:
Thickening formula or expressed breast milk with rice cereal is an older remedy for infant reflux. It isn't universally recommended today.
If you thicken your baby's formula, you might notice less spitting up — but some research suggests that the number of reflux episodes actually remains the same. Thickening formula also adds potentially unnecessary calories to your baby's diet, and might lead to choking or other problems during feeding.
Thickening expressed breast milk with rice cereal isn't likely to be effective because the enzymes in breast milk break down the starch in the cereal — which quickly thins the milk.
Remember, infant reflux is usually little cause for concern. Just keep plenty of burp cloths handy as you ride it out.