When your baby is spitting up many times a day and seems very unhappy with feedings, they may have gastroesophageal reflux disease. Although your baby will need assessed by their doctor, symptoms include:
- Frequent spitting up, often with pain
- More uncomfortable when sitting than when upright on chest
- Gagging, choking, coughing, burping or frequent hiccuping
- Bad breath
- Uncomfortable when laid down, sleeps poorly
A baby with severe GERD could also:
- Cry excessively, appearing in pain.
- Have poor weight gain, weight loss after gaining appropriately in early days/weeks, or failure to thrive.
- Have problems feeding or swallowing.
- Have hoarseness, chronic nasal congestion, frequent ear infections, chronic cough.
- Have green/yellow spit ups or even signs of blood.
- Arch with feeding or burping to relieve discomfort by stretching esophagus.
- Have breathing issues including wheezing, aspiration, asthma, apnea, bronchitis, pneumonia, episodes of cyanosis.
In addition to the management of general reflux there are additional measures you can take:
- Short, frequent feedings.
- Keep baby erect and calm as much as possible after feeding, holding baby against your chest.
- Lots of skin-to-skin and gentle rocking/swaying motions.
- Nursing in the tub, where baby is often more calm.
- Non-nutritive sucking which can help reduce irritation and encourage stomach emptying.
- Move baby as little as possible and avoid rough, bouncy movement or handling
- Eliminate all smoking anywhere around baby. If smokers come to visit, they must wash all exposed skin and be given other clothing to cover their clothes.
- Eliminate caffeine in your diet as it can contribute to reflux.
Roll your baby on their side when changing diapers rather than lifting their bottom up higher then their stomach to reduce opportunity for stomach contents to move back into the esophagus.