Fussy with feeding? How do you know if your baby is suffering from heartburn or reflux? Explore what to try to help with fussy feedings and when to see your pediatrician
Welcome back to First Breaths to First Steps. I’m Bev Garrison, your host. Today, we’re going to talk about heartburn or reflux in newborns. So common to have parents come in and especially within the first couple of days or weeks of life, complaining that their babies are fussy when they’re feeding and just seem irritated. And the next question is usually, are we having reflux? Are they having heartburn?
Today I thought we’d go through kind of define what that is. Why newborns get that so commonly. Symptoms, you may see them present with. As well as at home treatments, we could try to see if we can get things better. And also when to seek medical intervention.
So let’s start with what is reflux or heartburn? IF you think about our anatomy and how we’re built. Food, liquid, everything starts in our mouth. We swallow. It goes down a tube, that we call our esophagus, and meets into our stomach. At the top of the stomach where that tube comes in. There’s a little round sphincter of muscle that helps to keep things down into our stomach. But for babies, and this is very normal when they’re first born, that ring of muscle may not be very mature and kind of loosey goosey. So it allows things to travel back and forth- from the stomach, back up into the esophagus where it doesn’t belong. The reason this is a problem is the stuff in our stomach, it tends to be acidic. When it comes up, into areas that aren’t ready to handle acid. It can cause some irritation and inflammation and make babies uncomfortable.
Why do we see it? In newborns, it’s pretty common. Sometimes they will reflux or have things move up and down that esophagus multiple times a day. But just, as I said, the ring of muscle at the top, maybe premature. If babies are born early, that ring is definitely not as strong as normal. We also are primarily feeding a liquid diet, either formula or breast milk and then we’re laying kids down. Gravity also works. When you lay down things, moving from the stomach and going back up the esophagus causing some pain – can be more common when you’re laying down.
So what sort of symptoms would you see in babies that have reflux? Probably the primary thing that parents report back is “my babies are fussy with feeds.” They’re arching their back. Spitting up. Sometimes that spit up is very projectile and forceful in nature. In older children or kids that can communicate with us. They’ll sometimes complain of a sore throat pain with swallowing or a funny taste in their mouth. Obviously our babies can’t do that, but, w e will see them act a little bit more fussy surrounding feeding.
What are some things that you can try at home? Now realize most reflux will resolve on its own and you won’t have to do anything. But things that are recommended that can be helpful. Number one is burping your baby and burping your baby frequently. We recommend between ounces, if you’re bottle feeding or between breasts, if you’re breastfeeding.
It’s a good idea to try and keep babies upright after feeds for a little bit of time. Remember I said that g ravity can harm us, when we lay down that primarily liquid diet is able to easily flow back up and cause irritation. So if you can keep babies upright. Burping holding them, putting them in a bouncy seat or car seat, with them sitting in that type of position. Might help to decrease things from moving from the stomach.
Another thing to think about would be elevating the head of the crib or the bassinet. You can do this by rolling a hand towel or a bath towel and placing it underneath the mattress. That way there’s nothing loose on top of the mattress that could get in front of your baby’s face and cause breathing problems. Or you could also even purchase a wedge type pillow that can be placed underneath the mattress.
Another suggestion of something you could try at home, if you’re bottle feeding would be a lower airflow bottle, like a Dr. Browns. A lot of times we’ll notice that these babies that have reflux or also gassy. if we can decrease the amount of air in their belly, sometimes that’s helpful.
Smaller more frequent meals. So instead of giving a large volume at one time, sometimes if we make that smaller. It won’t overstretch the stomach and allow contents to come back up.
Sometimes we try all of these lifestyle changes and it just doesn’t help. We need to consider medications to help neutralize that acid. Or decrease the amount of acid that’s made.
When should we seek medical intervention? Anytime you’re worried. I think it’s always good to reach out, especially if you’re a new parent. You’ve never done this before. And so you should have a lot of questions. There’s really no need to sit at home and worry about it. You should run it by somebody just to make sure that everything is okay.
But just, like I said before, If you’ve tried the lifestyle things that are easily d one at home and you’re not seeing much success- that’s a good reason to go in. If you’re worried about weight loss or that your baby is not gaining enough weight. That’s also a very good reason to go in. We always want to make sure that we’re taking into account what the spit-up looks like. If there’s blood. If it’s looks like coffee grounds. If it’s green or yellow in color. Those would all be good reasons to go in and see your primary care provider. As well as if there’s blood in the stool. The belly seems very distended or very firm and baby is just increasing fussy behavior not settled. – Those are all good reasons to see someone in the healthcare field. Continuing to spit up after six months would be uncommon for reflux, mainly because babies are sitting upright more. And we’re weighing down their food by offering solids. So if you’re seeing spit up past that timeframe, it probably is a bit to seek an evaluation. If your baby is definitely refusing to eat. Is not having as much of an appetite. That’s also a very good reason to go in and seek medical care.
Lots of different words for heartburn, reflux, fussy babies with feeding. Just remember it’s not uncommon to see that in the newborn period. There definitely are some things to do at home. But If you’re trying these things at home, and it’s really not working, and your baby is continuing to be fussy. All good reasons to go in and be seen.
If you found the information in this podcast, helpful, you can click on the link below in the description and download the notes from this podcast. Also if you’re interested in working with me from first breaths to first steps and coaching your newborn you can also click on that description and contact me. Until next time be well