When your baby’s spit­ting up causes him dis­com­fort, there are things you can do to help

Your Baby & Toddler - - FRONT PAGE -

Young ba­bies with mild re­flux are of­ten rest­less dur­ing and af­ter a feed, and they may strug­gle to sleep. You may also no­tice your baby cry­ing with a red face, tight fists and an arched back.

Ba­bies with se­vere, on­go­ing re­flux lose weight be­cause they rarely fin­ish a feed. They also be­come pale and cough a lot. In ex­treme cases of GORD, the baby may even vomit blood. If you sus­pect your baby has se­vere re­flux, take him to a doc­tor as soon as pos­si­ble.


Phys­i­o­log­i­cal re­flux can be caused by feed­ing too quickly (so baby swal­lows air) or an im­ma­ture di­ges­tive sys­tem. Re­flux can also hap­pen when the stom­ach takes longer to empty (the valve lead­ing into the in­tes­tine may be too tight) and can be wors­ened by tight clothes and a nappy that’s on too tight.

With this type of re­flux the di­ges­tive sys­tem sim­ply needs time to ma­ture. Breast- and bot­tle-fed ba­bies have the same in­ci­dence of re­flux, although breast­fed ba­bies usu­ally have shorter episodes of it.

Early, tem­po­rary and mild re­flux is of­ten as­so­ci­ated with a weak gas­tric valve where the oe­soph­a­gus en­ters the stom­ach. This valve tight­ens to make sure milk stays in the stom­ach. When it’s weak, milk can leak back into the oe­soph­a­gus. If it’s too tight, milk col­lects in the oe­soph­a­gus and when it be­comes too full, the milk is sent back into the mouth.

On the other hand, se­vere re­flex is of­ten as­so­ci­ated with con­gen­i­tal ab­nor­mal­i­ties of the oe­soph­a­gus. Ex­am­ples in­clude a mild to se­vere hia­tus her­nia (weak­ness in the di­aphragm where there is an open­ing for the oe­soph­a­gus to pass through) or a con­nec­tion be­tween the oe­soph­a­gus and trachea (called a TOF or tra­cheoe­sophageal fis­tula). Th­ese will need ur­gent cor­rec­tive surgery.

Ba­bies with con­gen­i­tal con­di­tions such as Down syn­drome, cere­bral palsy or cys­tic fi­bro­sis, or ab­nor­mal­i­ties of the air­way or oe­soph­a­gus, of­ten strug­gle with se­vere re­flux. When this hap­pens, the re­flux needs spe­cial mon­i­tor­ing, fol­low-up and treat­ment ide­ally in­volv­ing a team of spe­cial­ists.

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