Feeding tips to reduce spitting up and acid reflux in babies

Infants and babies who spit up a lot may be suffering from heartburn, which is also known as acid reflux. Since babies can’t understand or explain how they feel, parents and caregivers should watch for signs of acid reflux, such as:

• Excessive spitting up
• Colicky behavior
• Trouble swallowing
• Refusing to feed

When these symptoms become chronic, your baby may have gastroesophageal reflux disease (GERD).

Recommendations to help prevent acid reflux and GERD in babies include:

• Holding infants upright after feedings
• Not overfeeding
• Burping infants in the middle of feedings (e.g., after 2 ounces of formula), as well as at the end

GERD in Formula-Fed Babies

Infants and babies who spit up excessively often have an intolerance to cow’s milk protein, which is found in many formulas. A baby’s digestive tract is still developing, and some infants have more sensitive stomachs than others. Most infants get over this intolerance by their second or third birthday, if not earlier.

Switching the baby to an over-the-counter hypoallergenic formula often helps prevent symptoms. When hypoallergenic products are made of cow’s milk, the proteins in the milk are broken down to make them easier to digest.

Hypoallergenic formulas on the market range from hydrolyzed products to amino acid-based products. Amino acid-based formulas process (i.e., break down) milk proteins even more than hydrolyzed formulas. But amino acid-based products are also more expensive. So parents might want to try a hydrolyzed formula first.

GERD in Breastfed Babies

In infants who are exclusively breastfed, the baby may be reacting to traces of milk protein in the mother’s milk, or to other foods in the mother’s diet. Mothers may try eliminating dairy from their diet to see if that helps.