Burping and Reflux

August 4, 2010, 12:24 pm Dr Ginni Mansberg practicalparenting

Over half of all babies spit up regularly in the first year of life. Is it just burping or is it reflux?

PP - reflux
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Don’t you just love it? You’re all dressed up and ready to go on a long-awaited night out. A quick kiss and cuddle goodnight for bub and, hey presto, the Chanel No. 5 suddenly has a top note of Parmesan and it looks like a tub of cottage cheese has been upended on your shoulder.

You are not alone. Over half of all babies spit up regularly in the first year of life. This is known as reflux and it occurs when the milk your baby has drunk curdles in the acid in his tummy and is propelled upwards into his food pipe, out of his mouth and onto your shoulder.

Spitting up is a bit smelly and creates extra work in the laundry but doesn’t really bother most babies. It tends to peak at 4 months then drop off by 12 to 18 months, when your tot starts spending more time upright and the valve that separates his stomach and food pipe works more effectively.

But when a chucky baby stops putting on or loses weight, fusses around and rejects feeds, or gets breathing problems because the refluxed milk is going back down the wrong way, he has crossed the line from reflux to gastro oesophageal reflux disease (GORD). As you can imagine, this is relatively uncommon.

Is it reflux?

I see a lot of babies who don’t have those symptoms but spit up and seem unhappy. The question is: is the reflux causing this baby’s unsettled state?

All babies cry. Most babies that have a really hard cry will go stiff and arch their little backs, but that doesn’t necessarily mean they’re in pain. The average 6-week-old baby cries more than an hour a day. Over a quarter of 6-week-old babies cry more than two hours a day. By 3 months the amount of crying starts dropping off. Most babies’ crying is not due to reflux.

For GORD we look at medication to fix the problem. But for your typical chucky baby, try these tips:
  • Burp a breastfed baby after each breast and a bottlefed baby after every 30-60ml to minimise the chance of
a big up-chuck.
  • Don't feed baby again after he spits up. Wait until the next feeding time.
  • Keep baby upright for at least 20 minutes after feeding to let gravity help him get it all down.
  • Avoid tightly belted outfits that put pressure on his tummy.
  • Be prepared! Have a towel over your shoulder to capture the fall-out.

A note on burping
Many experts say ‘wind’ is a myth and burping a baby is unnecessary. Maybe, but I can’t see a downside of burping.

If, despite your efforts, you can’t get a bleat out of baby, don’t worry too much.

However if your baby spits up and fusses around meals, refuses the breast or his bottle, is not growing or is unsettled unless you hold him upright, have him checked out ASAP.

Related Articles
* Burping and reflux
* Feeding routines
* Night-time feeds

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