Parenting tips: Reflux

6 03 2008

Friends who recently had their newborns called to ask about reflux. Their PDs (2 different friends) diagnose their babies as having gastroesophageal reflux (GERD). There’s a full article describing this at

Symptoms include frequent vomitting, or spitting of milk after their feeds.

More important are the techniques that I’ve learnt, especially for bottle feeding.

– Burping the baby. We were very persistent during the early months on burping because one of our babies had this problem of vomitting her milk after a full feed.

– After burping, let the baby lie in an inclined position. Fold the nappy cloth or use a small baby pillow to add the height. You can also try adjusting the angle of the cot mattress or playpen by adding cushions below the mattress.

– Check that the milk flow from the bottle teats is not too fast. If the milk flow is very fast, it increases the amount of air that the baby may suck.

Chances are, if the milk flow is too fast, the baby doesn’t know when to stop and may just keep drinking. Frequent feeds, lesser volume each time could help ease the situation.

– Examine if the baby is sucking in air from the bottle. The teat should always be fully covered with milk. Different brands of teats have their ways of resolving this, either by trapping the air (such as Avent), or having a small hole to allow air to escape, just before the milk goes to the baby (e.g. NUK). Using universal teats, some would not tighten the milk bottle all the way, so that the air can escape. (I tried this method, but it only ended up with the milk seeping out of the bottle).

Friends said that their doctors recommended milk thickening so that the stomach can hold the milk longer, thereby avoiding the vomitting. Personally I do not agree with the method. With the thick milk, it also means that the teat hole has to be wider to allow the solution to flow through.  It’s harder for the baby to digest and drink thick milk.

Babies generally outgrow reflux as they get older, so parents should not worry too much. If the vomitting/spitting is combined with other symptoms such as loss of appetite or not gaining weight properly, get the doctor to check and advise appropriately.