GERD in Babies

Gastroesophageal Reflux Disease (GERD)

There are two types of reflux, plain GER, which is mostly just “spitting up" and then there is GERD, which refers to a chronic problem called Gastroesophageal Reflux Disease.

GERD occurs when the sphincter muscle at the top of the stomach relaxes too much and fails at keeping the stomach contests down. 

In GER babies, spitting up is a regular occurrence, but it does not cause any other problems. As soon as other problems arise, it is considered GERD. 

GERD in babies can lead to pneumonia, asthma, apnea, and slow heart rate.

Babies with GERD will usually have outgrown any symptoms by the age of 1. 

What are the Symptoms of Infant GERD

•    Failure to thrive.

•    Fussiness while breastfeeding. 

•    Arching of the back while breastfeeding. 

•    Breast refusal.

•    Seems that the baby has pain while swallowing. 

•    The baby has difficulty sleeping. 

•    The baby has a chronic cough. 

•    The baby spits up blood. 

Things that Contribute to GERD (Make it Worse)

•    Nasogastric tubes used for feeding preemies. 

•    When there is exposure to tobacco smoke. 

•    When there is an allergy to cow’s milk. (usually found in half of all babies with GERD)

•    When antenatal steroids such as Betamethasone and Dexamethasone are taken. 

•    Other conditions sometimes coexist with GERD. Some of these include heart failure, cerebral palsy, gut abnormalities, and prematurity.

GERD in Babies
Impact on Breastfeeding

A baby may fuss so much at the breast that he/she is not getting in enough milk, or that a mother's milk supply starts to decrease.

The mother may feel extremely frustrated, especially if her baby pulls away from the breast. She might start to wonder if her milk is to blame for her baby’s discomfort.

The mother should get her baby tested for allergies.

She should continue to breastfeed, as breast milk contains protection against reflux. 

Making Breastfeeding Easier

reclined breastfeeding, breastfeeding position

•    Try to feed your baby in a more upright breastfeeding position. Such as the straddle hold or reclined position. This will help keep the milk inside your baby’s stomach. 

•    Avoid putting any pressure on your baby’s tummy during breastfeeding and burping, pressure can increase spitting up episodes. 

•    Try to keep your little one in upright positions after feedings. 

•    Stay on one breast per feeding: Ensuring that your baby gets the hindmilk and less volume of milk at one time, this helps a baby get more calories with less straining on the stomach. 

•    Feed more frequently, but shorter time periods as not to overfill your baby’s tummy. 

•    An inclined angle of about 45°, can keep your baby comfortable while sleeping. 

•    Avoid car or baby seats, which curl a baby’s tummy inwards, putting pressure on the abdomen. 

•    Avoid any cereals to thicken feeds. This can make reflux worse. 

•    During the day, you can keep your baby on his/her tummy while awake and alert. 

•    Allowing your baby to lie on his/her left side while sleeping, can help reduce reflux. 

•    If your baby is not getting in enough calories, a fortifier can be added to the expressed breast milk. 

Tracy Behr, CBC, CLD (CBI)

Reference: Breastfeeding counselor course through Child Birth International on the physiology of breastfeeding/Health issues/GERD in babies. 

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