How to Treat Acid Reflux in Newborns

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Many newborns experience gastroesophageal reflux (GER), which is when food backs up from their stomach and causes them to spit up. It’s common in infants younger than 6 months old, and usually stops by the time they’re 12-14 months old. However, a more severe and ongoing reflux, called gastroesophageal reflux disease (GERD), causes bothersome symptoms that may lead to complications. [1] Seeing your newborn experience discomfort from acid reflux can concern or upset you, but by making some lifestyle changes or using medication, you can treat their acid reflux.

Part 1
Part 1 of 2:

Making Lifestyle Changes

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    Watch your baby to see if they exhibit symptoms of acid reflux before making lifestyle changes. Typical signs and symptoms of acid reflux in newborns include: [2]
    • Spitting up
    • Vomiting or regurgitation
    • Not gaining weight or growing
    • Being irritable during feedings
    • Loss of appetite or refusing to eat
    • Wheezing, coughing, or hoarseness
    • Choking, gagging, or difficulty swallowing
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    Talk to your pediatrician before changing the way you feed your baby with a bottle. Depending on the severity of your baby’s reflux, they may suggest the following changes: [3]
    • Feed your baby more often, but reduce the amount of formula or milk you give them to avoid reflux.
    • Thicken the formula with oatmeal, carob bean thickener, or another type of thickener that your pediatrician recommends.
    • Try a different brand of formula, or remove cow’s milk protein from your baby’s diet. [4] If you’re breastfeeding, remove all forms of dairy from your diet. [5]
    • Make sure your baby’s bottle nipple is the right size. This allows your baby to get the right amount of milk without swallowing air. If your baby is choking, coughing, has difficulty swallowing, or is refusing to eat, try a slower flowing nipple. [6]
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    Babies who are breastfed may experience slightly less reflux because breast milk digests faster than formula. [7] Similar to bottle feeding, changing your breastfeeding routine may help treat your newborn’s reflux, but talk to a lactation consultant or a breastfeeding medicine specialist before making any changes. [8]
    • Breastfeed for shorter amounts of time, but more frequently throughout the day to help reduce reflux. [9]
    • Eliminate different foods from your diet to see if this eases your newborn’s reflux. For example, you could avoid dairy, beef, or eggs to see if one might be the culprit. [10]
    • Thicken breast milk with rice cereal or another thickener that your pediatrician recommends. [11]
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    If your baby seems irritated while feeding, stop the session, burp your baby, then begin feeding again. Your baby may reflux more often when burping with a full stomach, so increased burping may relieve pressure in their belly and prevent reflux. [12] Use the following schedule as a guideline for burping: [13]
    • Burp your baby every 2 to 3 ounces (60 to 90 mL) if you bottle feed, or each time you switch breasts if you breastfeed.
    • Change your baby’s position if they don’t burp after a few minutes.
    • Always burp your baby when feeding time is over.
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    Keeping your baby in an upright position may relieve reflux or prevent acids from creeping up. Make sure to hold them upright for about 20 to 30 minutes after you feed them. [14]
    • Keep your baby upright over your shoulder or sitting on your knee. [15]
    • Try not to bounce your baby around or provide too much stimulation after a feed. [16]
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    Doctors recommend that babies sleep on their backs to minimize the risk of sudden infant death syndrome (SIDS). [17] There is no evidence that placing a baby on their side or stomach helps with reflux. [18] However, there is evidence that babies placed on their side or stomach are at higher risk for sudden infant death syndrome. [19]
    • Place your baby to sleep on a firm mattress, and make sure their crib has no blankets, bumpers, or stuffed animals that might suffocate them. [20]
    • Do not raise one end of the crib or elevate the mattress with a foam block, wedge, or pillow. Keep your baby on a firm, flat, and level sleep surface. [21]
    • Even if your baby is regurgitating or vomiting, place them on their back. Babies automatically cough or swallow fluid that they spit up because of their gag reflex, and this naturally prevents choking. [22]
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    There is a natural product called “gripe water” that some people believe eases gas, reflux, and other baby ailments. There is no scientific evidence that gripe water is effective in treating reflux, but consult with your baby’s doctor if you are interested in trying a natural remedy. [23]
    • Be aware that the World Health Organization (WHO) doesn’t recommend giving gripe water to babies under 6 months. [24]
    • Make sure to speak to your doctor before giving your baby gripe water.
    • Many brands of gripe water include ingredients like fennel, peppermint, lemon balm, chamomile, ginger, and sodium bicarbonate. [25]
    • If you want to trial gripe water with your baby, look at the ingredient list closely. Avoid formulations that contain sugars or alcohols. [26]
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Part 2
Part 2 of 2:

Getting Medical Treatment

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    If making lifestyle changes doesn’t ease your newborn’s reflux or their symptoms get worse, schedule an appointment with a pediatrician. [27] You should also see your baby’s pediatrician if they have any of the following symptoms: [28]
    • Crying more than usual or being extremely irritable
    • Failing to gain weight or gaining less weight than expected for their age
    • Problems swallowing or breathing
    • Projectile vomiting
    • Vomiting in large amounts
    • Vomit that contains blood or looks like coffee grounds
    • Vomiting with bile (making the vomit green or yellow in color)
    • Vomiting or regurgitation that begins when they’re younger than 2 weeks or older than 6 months
    • Rectal bleeding or stools that contain blood
    • No wet diapers for 3 hours or more, or a lack of energy
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    A pediatrician will examine your baby and ask you questions about their symptoms. If symptoms suggest that your baby may have a gastroesophageal reflux disease (GERD) complication or another type of health problem, your pediatrician may recommend further medical testing. [29] Your doctor may order one of the following tests: [30]
    • Upper GI series
    • Esophageal pH and impedance monitoring
    • Upper gastrointestinal (GI) endoscopy and biopsy
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    Depending on the outcome of your doctor’s visit and possible testing, your doctor may suggest lifestyle changes and/or prescribe medication. [31] Reflux medications usually lower the amount of acid the stomach makes, which may improve symptoms and heal the lining of the esophagus. However, infants taking these medicines may have a higher chance of experiencing certain types of infections. [32]
    • Follow your doctor’s dosing instructions. Do not give your baby medication unless your doctor tells you to. [33]
    • Your doctor will likely prescribe proton pump inhibitors (PPIs) or H2 blockers to decrease acid production. [34]
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    In very rare cases, some babies may need surgery to tighten the muscle that blocks food from coming back up. [35] The procedure, called fundoplication, is generally only done on babies that have severe breathing problems with their reflux. [36]
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      References

      1. ↑ https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants/definition-facts
      2. ↑ https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants/symptoms-causes
      3. ↑ https://my.clevelandclinic.org/health/diseases/reflux-in-babies
      4. ↑ https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants
      5. ↑ https://my.clevelandclinic.org/health/diseases/reflux-in-babies
      6. ↑ https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/choosing-a-bottle-flow-rate
      7. ↑ https://kidshealth.org/en/parents/breast-bottle-feeding.html
      8. ↑ https://my.clevelandclinic.org/health/diseases/reflux-in-babies
      9. ↑ https://my.clevelandclinic.org/health/diseases/reflux-in-babies
      1. ↑ https://kidshealth.org/en/parents/breastfeed-eating.html
      2. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671396/
      3. ↑ https://www.hopkinsmedicine.org/health/conditions-and-diseases/gerd-gastroesophageal-reflux-disease-in-children
      4. ↑ https://kidshealth.org/en/parents/burping.html
      5. ↑ https://medlineplus.gov/ency/article/001134.htm
      6. ↑ https://www.childrens.health.qld.gov.au/health-a-to-z/reflux
      7. ↑ https://www.childrens.health.qld.gov.au/health-a-to-z/reflux
      8. ↑ https://www.cdc.gov/sids/Parents-Caregivers.htm
      9. ↑ https://www.childrens.health.qld.gov.au/health-a-to-z/reflux
      10. ↑ https://www.nichd.nih.gov/sites/default/files/publications/pubs/documents/SIDS_QA-508-rev.pdf
      11. ↑ https://www.cdc.gov/sids/Parents-Caregivers.htm
      12. ↑ https://safetosleep.nichd.nih.gov/reduce-risk/back-sleeping
      13. ↑ https://www.nichd.nih.gov/sites/default/files/publications/pubs/documents/SIDS_QA-508-rev.pdf
      14. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4668494/
      15. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356971/
      16. ↑ https://www.preventallergies.org/blog/how-do-i-know-if-my-baby-has-reflux
      17. ↑ https://bpac.org.nz/bpj/2011/november/infant-reflux.aspx
      18. ↑ https://www.nationwidechildrens.org/conditions/gastroesophageal-reflux-disease-gerd-in-infants
      19. ↑ https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants/symptoms-causes
      20. ↑ https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants/diagnosis
      21. ↑ https://medlineplus.gov/refluxininfants.html
      22. ↑ https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants/diagnosis
      23. ↑ https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants/treatment
      24. ↑ https://medlineplus.gov/refluxininfants.html
      25. ↑ https://medlineplus.gov/refluxininfants.html
      26. ↑ https://medlineplus.gov/refluxininfants.html
      27. ↑ https://www.stanfordchildrens.org/en/topic/default?id=gastroesophageal-reflux-disease-gerdheartburn-in-children-90-P01994

      About This Article

      Article Summary X

      If your newborn is vomiting, refusing to eat, or struggling to swallow, they may be suffering from acid reflux or GERD, which are actually very common conditions among newborns under 18 months of age. However, there are things you can do to help your newborn in the meantime, such as burping them more and adapting the way you bottle feed or breastfeed them, since this could help relieve or prevent their acid reflux. For example, you could increase the frequency of your baby's feedings, but reduce how much you give them at each feeding, so there is less pressure on the muscle that keeps food from refluxing. If you notice your baby is not gaining weight or is vomiting green or yellow, take them to the pediatrician. For more tips from our Medical co-author, including how to use natural remedies to treat your newborn's acid reflux, scroll down.

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