Reflux

www.babycentre.co.uk)

What is reflux?

Reflux is what happens when your baby's stomach contents come back up into his food pipe (gullet or oesophagus) or even into his mouth. The long name for reflux is gastro-oesophageal reflux disease.

Babies get reflux because the muscular valve at the end of the food pipe, which acts to keep food in the tummy, hasn’t developed properly yet. This means that when your baby’s tummy is full, food and acid can come back up. This can cause him to bring up small amounts of milk (possetting) or even vomit.

During the first year of your baby's life, the muscular valve gradually gets stronger and better at keeping food down, so his chance of having reflux decreases. About half of babies will get some reflux during their first three months, but it’s only a real problem for a small percentage of these. By 10 months only about five per cent of babies have reflux.

How will I know if my baby has reflux?

Your baby may bring up a little milk after a feed or have hiccups. He may occasionally cough after bringing up milk if a little has gone "down the wrong way".

This is normal and as long as your baby is otherwise well, you don't need to worry. Just make sure you always have a tissue or muslin cloth to hand. Both formula-fed and breastfed babies can have reflux.

Should I take my baby to see a doctor?

Bringing up a little milk after feeds is nothing to worry about. But speak to your health visitor or doctor if you notice any of the following:

• your baby's reflux is happening more than five times a day on a regular basis
• your baby cries excessively after feeds
• your baby regularly vomits
• your baby coughs a lot after feeds

Are there any treatments for reflux?

If your baby’s reflux is mild, and he’s still feeding well and isn’t too upset by it, then the following may help:

• hold your baby upright for up to 20 minutes after each feed
• try giving your baby smaller but more frequent feeds
• if you bottle feed your baby, burp him every two or three minutes during feeds

If your baby’s reflux is more severe, see your doctor, who may advise these treatments:

• Adding feed thickener to expressed breastmilk or formula for two weeks, or using a pre-thickened formula. Feed thickeners and thickened milk are available on prescription from your doctor, although some you may be able to buy from your pharmacy. Only use them on the advice of your health visitor or doctor and stop them after two weeks to check that your baby’s reflux has improved.
• An antacid such as infant Gaviscon. You will need to get this on prescription from your doctor. If you are breastfeeding, you can add it to expressed breastmilk or cooled boiled water, or it can be mixed in with your baby’s formula. If you’re unsure about how much to give your baby, check the packet or ask your pharmacist or doctor for advice.

The symptoms of reflux can be very similar to the symptoms of a cow’s milk allergy or intolerance. If you breastfeed your baby, you may need to stop drinking cow’s milk or having food or drinks containing cow’s milk. Or if your baby is formula-fed ask your doctor about giving him a hypoallergenic formula for a couple of weeks to see if it helps.

If there is doubt about the diagnosis of reflux, then your doctor may refer your baby to a paediatrician.

Your baby may also be referred to a paediatrician if:

• there is blood in your baby’s vomit
• your baby becomes anaemic (he doesn’t produce enough red blood cells)
• your baby has persistent coughing or frequent chest infections
• your baby doesn’t gain enough weight or begins to refuse feeds
• your baby is having difficulty swallowing

These symptoms are rare, but see your doctor if you are worried about any of them. Remember that most babies will bring up a little milk after feeding, and without complications. Reassure yourself that things will get better as your baby grows.