Reflux and Breastfeeding

Reflux occurs when a baby's stomach contents flow up and out of the stomach. The contents might only reflux into the esophagus (the tube that carries food and liquid from the mouth to the stomach), or they may come all the way up to the mouth and cause the baby to spit up. All babies experience reflux to some degree, because the valve at the top of their stomach is not very strong yet. (That's also why most babies spit up.) However, for some babies who reflux too much, the acid in their stomach's contents causes irritation of the esophagus and leads to pain; reflux can cause the baby to feel uncomfortable may need medical attention.

Reflux in the breastfed baby is often related to breast milk oversupply and may resolve itself simply through treatment of the oversupply. If you suspect reflux, consult your baby's doctor in addition to working with your lactation consultant.

Here, what you should know about reflux in infants:

  • Crying after many or most feedings can be a symptom of reflux. Reflux can be "silent," meaning stomach contents reflux only into the esophagus and may cause pain, but the baby may not spit up or vomit.
  • Most babies outgrow reflux by 9 to 12 months.
  • Babies may try to "posture" to relieve reflux pain, by arching their back to lengthen the esophagus and reduce discomfort.
  • Some babies either under-eat or overeat because of reflux. They might overeat because suckling causes stomach contents to go back down into the stomach and can also soothe the irritation in the esophagus. They might under-eat because they associate feeding with the after-feeding pain or because swallowing might hurt.
  • Babies have a different response to pain than adults. When they feel pain, it leads to an increased sensation of pain, which leads to more pain, which increases the sensation, and so on. Therefore, what felt like a small amount of pain in the beginning may feel like a large amount of pain later. Adults generally do just the reverse; as they get used to pain, the severity of it seems to diminish.
  • Excessive caffeine in Mom's diet can contribute to reflux in the breastfed baby.
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