Feed Smaller Amounts:
- Mild reflux occurs in most infants (50%).
- Usually it doesn't cause any discomfort or complications.
- Infants with normal reflux do not need any tests or medicines.
- Reflux improves with age.
Longer Feeding Intervals:
- Skip this advice if age less than 1 month or not gaining weight well.
- Bottlefed: Give smaller amounts per feeding (1 ounce or 30 ml less than you have been). Keep the total feeding time to less than 20 minutes (reason: overfeeding or filling the stomach to capacity always makes spitting up worse).
- Breastfed: If you have a plentiful milk supply, try nursing on 1 side per feeding and pumping the other side. Alternate sides you start on.
Loose Diapers: Avoid tight diapers. It puts added pressure on the stomach. Don't put pressure on the abdomen or play vigorously with your child right after meals.
Vertical Position: After meals, try to hold your baby in the upright (vertical) position. Use a front-pack, backpack, or swing for 30 to 60 minutes. Reduce time in sitting position (e.g., infant seats). After 6 months of age, a jumpy seat is helpful (the newer ones are stable).
Less Pacifier Time:
- Formula: Wait at least 2½ hours between feedings.
- Breastmilk: Wait at least 2 hours between feedings.
- Reason: It takes that long for the stomach to empty itself. Don't add food to a full stomach.
- Constant sucking on a pacifier can pump the stomach up with swallowed air.
- So can sucking on a bottle with too small a nipple hole. If the formula doesn't drip out at a rate of 1 drop per second when held upside down, clean the nipple better or enlarge the hole.
Expected Course: Reflux improves with age. Many babies are better by 7 months of age, after learning to sit well.
Call Your Doctor If:
- Burping is less important than giving smaller feedings. You can burp your baby 2 or 3 times during each feeding.
- Do it when he pauses and looks around. Don't interrupt his feeding rhythm in order to burp him.
- Burp each time for less than a minute. Stop even if no burp occurs. Some babies don't need to burp.
- Your baby doesn't improve with this approach
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. For more information, click here.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.