A common problem new parents often face is the issue of spitting up and reflux. Almost all babies spit up sometimes, but what’s normal, and when should parent’s suspect Gastro-Oesophageal Reflux Disease (or ‘GORD’ for short)? This post looks at the symptoms of GOR or Gastro-Oesophageal Reflux, which is normal spitting up, and GORD, Gastro-oesophageal Reflux Disease, where symptoms of reflux becomes troublesome, complicated and severe. Reflux generally occurs when the Lower Esophageal Sphincter (or LES) is weak, and so doesn’t prevent the stomach contents from flowing back up the oesophagus. GOR – The Happy Spitters! Whether they are bottle or breastfed, many babies naturally spit up or posset because their digestive systems are immature and stomachs very small. Spitting up often occurs if mum has an oversupply of milk, if milk let down is fast and forceful or if baby gulps and swallows air when feeding. Often in these cases good breastfeeding support can help reduce spitting up. Many healthy babies will grow out of spitting up by around 7 months, and most will have stopped by 12 months, as the LES matures and becomes stronger. So, if your baby spits-up, but is growing, gaining weight, generally happy and content and not uncomfortable when she spits up, then she is what doctors and paediatricians call a ‘Happy Spitter’. Usually, this is a laundry issue rather than a medical problem; however consult a health professional or medical practitioner if you have any concerns. Could it be GORD? On the other hand, a small percentage of babies suffer with Gastro-oesophageal Reflux Disease (GORD) which is very different from normal spitting up. These babies typically suffer pain and burning with when the acidic stomach contents travel back up the oesophagus. Symptoms include frequent spitting up and/or vomiting with discomfort, crying, gagging, frequent burping and wind, bad breath, poor sleep, arching of the torso, fussiness and sore throat. Feeding may be difficult, and result in poor weight gain or even failure to thrive. Babies who have Silent Reflux, may experience GORD symptoms but there will be no visible regurgitation or possetting making diagnoses difficult. The severity of GORD symptoms varies between individual babies and children, and medical involvement is needed for accurate diagnoses and treatment. Medical treatment usually includes infant gaviscon and/or H2 receptor antagonists. Again, good breastfeeding support may help to improve the situation. There are further practical measures and strategies which may help to reduce and manage both GOR and GORD and complement medical treatment; these I will address in my next post. Sources and
Torgus, J. And Gortsch, G. (2007) The Womanly Art of Breastfeeding. (7th Ed) Plume.
ABM Breastfeeding Helpline: 08444 122949
Disclaimer: Doulas do not diagnose or medically advise. Information is provided to complement and not replace that of a medical professional.