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Acid reflux is common in babies - here's how to treat and prevent it for your child

Ashley Laderer,Jamie S. Hutton   

Acid reflux is common in babies - here's how to treat and prevent it for your child
Science3 min read
  • Babies often experience acid reflux because their lower esophageal sphincter isn't fully developed.
  • To prevent acid reflux, feed your baby small meals and tilt their head 30 to 45 degrees when feeding.
  • If your baby's acid reflux persists, discuss medication with a pediatrician.

Just like adults, infants can also experience acid reflux. But unlike adults, babies will often spit up when they have acid reflux.

Don't worry, it's normal. And most of the time, you just need a simple fix to help your baby feel more comfortable.

Why do babies have acid reflux?

Babies often experience acid reflux because their lower esophageal sphincter isn't fully developed.

The esophageal sphincter is the muscle that separates your stomach from your esophagus so that food and stomach acid doesn't back up from the stomach into the back of your throat.

However, a baby's esophageal sphincter is weak and under-developed, which makes it easier for food to come back up and cause acid reflux, as a result.

"Sometimes the babies overeat, and if they overeat, their food can come back up," says Danelle Fisher, MD, FAAP, pediatrician and Vice Chair of Pediatrics at Providence Saint John's Health Center. "Then over the first few months of life, that [muscle] tone tends to tighten up and they tend to spit up less."

Quick tip: The combination of overeating and the weaker lower esophageal sphincter is the main cause of acid reflux in babies.

Signs that your baby has acid reflux

One major sign of acid reflux is fussiness.

"Those babies [with acid reflux] will cry and fuss and be really uncomfortable especially around feeding times, which in most normal infants, is anywhere from 8 to 10 times in a 24 hour period," Fisher says. "So, these babies are pretty consistently fussy."

You might also notice wet burps and hiccups, or your baby might be having trouble eating or swallowing.

How to prevent your baby from getting acid reflux

There are two main ways you can prevent acid reflux in your baby before it even starts.

  1. Try smaller, more frequent feedings. "When you put a big load on the stomach, it's more likely that stuff is going to come back up," says Fisher. "Trying to do smaller but more frequent feedings will decrease the amount of spit-up and the amount of acid coming back up into the throat."
  2. Tilt your baby's head 30 to 45 degrees. Adjusting the baby's head positioning can make a big difference. "Another thing that is incredibly helpful is having the baby's head tilted up at about a 30 to 45-degree angle, both during feedings as well as for about 30 minutes after a feeding," says Fisher. "Gravity helps with digestion. Babies who are not able to sit up by themselves need to be propped up a little bit."

You don't necessarily have to hold the baby for a full 30 minutes - you can put them in a swing, car seat, or propped up bassinet. Mainly, you just want the head to be upright relative to the body.

Important: Avoid laying your baby down flat after feeding, as this can contribute to acid reflux.

How to treat acid reflux in babies

If smaller feedings and keeping the head upright doesn't seem to help, discuss medication with your pediatrician.

Fisher says medication isn't necessarily the first choice for treating acid reflux. Usually, meds are only prescribed in more severe cases, when the baby won't eat or has poor weight gain.

Then, pediatricians will usually prescribe either an H2 blocker, like Pepcid AC or Axid AR, or a proton pump inhibitor like Nexium or Prevacid.

Insider's takeaway

Fisher recommends taking your baby to the doctor to make sure that the symptoms are just due to acid reflux and nothing more serious, like a blockage in the GI tract.

Some red flags to look for are blood in spit-up or bowel movements and/or spitting up bile. In this case, take your baby to the doctor ASAP to figure out what's going on.

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