3 Important Questions About Your Baby's Reflux Answered
Let's Learn About ... Infant Reflux (part 2)
Previously, I covered the bascis about infant reflux. If you missed that article, please click here.
I have a few, more specific topics I promised I would go over in my previous post.
Should We Try a Medication for My Baby’s Reflux?
This is a tough one for me to talk to parents about, because as a doctor, I really want to “fix” things for you.
I used to prescribe medications more frequently than I do now. This is because I have read recent large studies that make me worry about the future effects of these medications (see links below):
If we change the pH of the gut, what are we doing to the trillions of bacteria, the natural gut biome that lives inside?
Part of the job of this gut biome is to help our body learn “friend from foe,” and a large study recently found that children under 6 months who were put on medications like Prevacid, Nexium, and Zantac (there are many meds available) or any antibiotic were found to be more prone to food allergies and asthma later in life.
Is it worth the risk? In some cases, yes. Some babies are in pain daily. Some babies even lose weight because they are fighting meals to avoid the pain. If a baby is not in daily discomfort, however, I’ll often try to talk parents into trying other methods before medicating. And we talk often about weaning it off or stopping it after a few weeks.
What Is Cow Milk Protein Intolerance and How Does It Relate to Reflux?
Cow milk protein intolerance (CMPI, also known as cow milk protein allergy) happens when a child’s immune system reacts abnormally to proteins found in cow’s milk (either in formula or mom’s diet) and soy. It is NOT the same as lactose intolerance, and it leads to injury/inflammation of the stomach and intestines.
Symptoms of CMPI usually involve the GI tract, like vomiting, abdominal pain, blood in the stool, mucousy stool and diarrhea. Prolonged issues in infants could lead to wheezing, irritability and poor growth / failure to thrive and eczema. Frankly, these are sometimes my fussiest little patients, and they often cry more than most babies do.
CMPI and reflux come hand-in-hand in a lot of kids I see. I often find that eliminating dairy and soy in a mom’s diet will help the reflux as well. Sometimes, kids need to be on special hypoallergenic or amino acid formulas.
Do I Elevate My Baby At Night So They Won’t Spit Up?
I remember many a morning looking into my son’s bassinet and seeing him sleeping peacefully in a puddle of old vomit. The guilt would overwhelm me! And it happened a lot. It was hard not to want to do something different.
But no, we don’t want you to elevate your baby when they sleep. We want you to keep them flat on their backs because this is safest.
While it may seem like elevating the head off the crib makes sense, according to the American Academy of Pediatrics, “There is no evidence that healthy babies placed on their backs are more likely to have serious or fatal choking episodes than those placed on their stomachs. But there is strong evidence that babies placed on their stomachs are at higher risk for sudden infant death syndrome (SIDS).”
There is not a need to a wedge under the mattress, or elevate the head of the bed with blankets or pillows. Studies have actually shown this doesn’t actually help reflux symptoms, anyway.
I’m hopeful that the take-home point in this two part article about reflux is clear: reflux, to some extent, is a part of every baby’s life in the first year. And in MOST kids, it completely resolves by age 12 months. Talk with your pediatrician about how you can help your baby if some of the options we’ve talked about here don’t seem to help!
Hope this helps. Remember, if you still have questions about this topic to read my first article.
Get to know Diane Arnaout, M.D.
Get to know Diane Arnaout, M.D., a Cook Children's pediatrician at Forest Park
"I didn’t realize how important the job of the pediatrician was until I had kids of my own. My education, experience in medicine, and cocky attitude made me feel like I knew it all before my first one came around. He proceeded to make me very aware of how little I actually knew.
Thankfully he survived, as did the next one, and they’ve helped me to grow and to help YOU, the parent, in so many ways. Sure I’m here to make sure your kids are healthy and happy at all ages. But I’m also here to make sure you’re educated, to make sure your family is thriving, and to make you feel confident in caring for your kids. From diaper rashes to sleep problems to school difficulties - I’m here to help.
I write a lot about common problems and ailments online – you can find me busy on Facebook and Instagram, and I write articles for the Cook Children’s Checkup Newsroom blog. A lot of stuff you’ll hear me say in the office will be typed out on there, too. And we’re in a day and age where the internet helps make connections – you can connect with me on there, or e-mail me anytime.
It takes a village to raise a child – and I’m so grateful to be a part of yours. And as Master Yoda teaches us – “Always pass on what you have learned.” I fully plan to!"