What You Need To Know About Reflux in Babies
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Time to read 6 min
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Time to read 6 min
Spit-up is normal for most infants, and doesn’t interfere with the day much. What about when your baby spits up a lot, or they seem to be uncomfortable and upset after and in between nursing sessions? Reflux is a common infant issue that can cause discomfort and be disruptive in the breastfeeding relationship. Reflux is a symptom and investigating the root causes can help you better understand what is the underlying cause and how to help your baby feel better.
Reflux symptoms usually present within the first 2 - 4 weeks of the infant's life. One study showed that more than 47% of infants have reflux symptoms at one month old and by seven months old, they report just 6.4% of babies are considered to have reflux. (1) Many practitioners say that reflux becomes better as the baby grows and matures and is rarely an issue past age one year old.
Children and adults can also suffer from reflux. Approximately 20% of adults have reflux. It is important to know that if your baby has reflux, they are at a higher risk for having reflux later in life. Up to 80% of adults with reflux also had it when they were a baby. (1) This does make one wonder if reflux ever really goes away or does it change over time?
* Silent Reflux is when babies are experiencing reflux, but they are not spitting up. The milk or formula stays in the esophagus and nasal passages for infants with silent reflux.
The most common explanation for reflux is that the lower esophageal sphincter (LES) is less developed in an infant and it doesn’t always remain closed so milk and food travel back up into the esophagus after eating. Although this seems to be true, it is not the end of the story. There is a relationship between gut health and the integrity of the LES being able to function well.
Some bacteria in the gut can cause more gas in your baby. This gas can put pressure on the LES and it is not able to stay closed when needed as easily. Improving gut health and supporting the gut, can help reduce gassiness and reduce symptoms of reflux.
For some people, sensitivity to dairy contributes to reflux symptoms, affecting 42 - 58% of infants. (2) Cutting out dairy improves symptoms within 2- 4 weeks of elimination of cow’s milk dairy from the baby’s diet. This further suggests that looking deeper into healing the gut is important to address the root cause of reflux for your baby.
The most common treatment offered to babies with reflux is medication. Antacids, H-2 blockers, and Proton pump inhibitor(PPI) medications work slightly differently but they all suppress the production of stomach acid. In the short term they may seem effective, but it is important to evaluate their risks. Stomach acid is required to digest food and break it down. Reducing the ability to produce this stomach acid can cause the problem to become worse with time, not better.
Antacid, H-2 Blockers, and PPI medications can deplete the body of key vitamins and minerals causing malabsorption of nutrients and lead to deficiencies. They have been shown to deplete vitamin B12, folate, vitamin D and vitamin C, and the minerals calcium, copper, phosphorus, potassium, zinc and iron and affect magnesium metabolism. All of these vitamins and minerals are important for your baby’s brain development. Deficiency may also lead to skin problems, later behavioral disorders and other negative health outcomes. There is evidence that PPI medication is no more effective than placebos for babies under one year old. (4)
Adressing the root cause of reflux improves your child’s overall health now and in the future. It may seem reflux symptoms go away as your baby gets older. However, it doesn’t magically go away. We just don’t see it the same as we did before. It may resurface looking different.
If we didn’t address the root cause of a symptom being expressed, it may seem to resolve. More likely, it just changes and expresses differently. We compensate. Our body wants to be in balance and will adapt to work as well as it can. Down the road, we may have other symptoms that appear from the same root problem as before.
Reflux can make days and nights rough for you and your baby. While it seems reflux is common fo infants, it is not a diagnosis but a symptoms from a deeper cause. There are ways to help soothe your baby and reduce discomfort right away while you address the cause of reflux and work on long term solutions. The symptoms may change over time and can look different for each baby. If you need help along the way, get in touch with your IBCLC for support and an individualized care plan for you and your baby for a more enjoyable breastfeeding journey.
https://ericazelfand.com/treating-reflux-in-babies/
https://www.uwo.ca/fhs/lwm/teaching/EBP/2008-09/Hammell.pdf
https://covingtonpediatrics.com/blog/babies-are-not-born-with-an-antacid-deficiency/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7909757/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416385/
https://mamarissa.com/infant-reflux-real-causes-and-real-solutions/
https://www.seattlechildrens.org/pdf/pe226.pdf
https://badgut.org/information-centre/a-z-digestive-topics/children-with-reflux/
https://drwillcole.com/functional-medicine/the-real-reason-behind-acid-reflux-how-to-heal
https://www.medicalmedium.com/blog/healing-acid-reflux
https://www.healthline.com/nutrition/heartburn-acid-reflux-remedies#TOC_TITLE_HDR_7
https://www.pediatricsresearchjournal.com/articles/fermented-food-guidelines-for-children.pdf