Parents should not worry about baby when their infant regurgitates their milk after meals. In the vast majority of cases, these discharges cease after one or two years and they do not affect the growth of the child. However, when these refluxes persist or are accompanied by pain, it is better to consult.
Baby Regurgitate Milk
Baby has just been breastfed or bottle fed and suddenly he sprinkles his mother or father with a jet of milk. This gastric reflux – or gastro esophageal reflux disease (GERD) as doctors call it – is not unusual. It is estimated that between 20 and 70% of infants regurgitate more than twice a day. It is around four months that these referrals occur most frequently but, in general, they stop at the end of the first year of life, or even the second. “This is not a disease, but a physiological phenomenon related to early childhood,” says Andreas Nydegger, head of the unit of gastroenterology, hepatology and pediatric nutrition of the Vaud University Hospital Center (CHUV ). Nothing to do with vomiting, which
The “overflow” is apparent
When we eat, food is transported through the esophagus to the stomach where it is digested. At the junction of these two organs is a sphincter that opens at the arrival of the food bowl and normally closes. However, if it does not work properly, the contents of the stomach goes back up into the esophagus. It’s gastric reflux.
This phenomenon occurs when “the emptying of the stomach is not fast enough; as a result, the overflow comes out of the mouth, “sums up the pediatrician in an imaginative way. These regurgitations can occur at any age, but toddlers are the first affected because their digestive tract has not completed its maturity. Their stomach especially has not yet acquired its final position. In addition, says Andreas Nydegger, “infants drink more than 100 milliliters of milk per kilogram per day, which would correspond, for an adult, to consume six to nine liters of milk a day. It is a huge volume in relation to the capacity of the stomach.
Under these conditions, we understand that sometimes the milk overflows and is returned by the mouth. For the parents, it is certainly confusing and even embarrassing when they have to change their clothes after the baby meal. But it does not feel any embarrassment, says the CHUV pediatrician. Anglo-Saxons also call infants subject to gastric reflux “happy spitters” or “happy spitters”. When the child is healthy, these regurgitations do not prevent him from gaining weight and have no impact on their growth. The doctor recommends to parents some simple precautions to mitigate the phenomenon ( read box ), but it advises them against using drugs.
The problem becomes more serious when the jets occur far from meals, frequently or abundantly, when the infant is in pain and crying, or if his regurgitation contains blood or bile. It is no longer a trivial physiological phenomenon, but an illness. It mainly affects premature children whose esophageal sphincter is more open, those born with a malformation of the digestive tract or those who have neurological disorders inducing poor coordination between the brain and the digestive tract.
Gastric reflux can be accompanied by complications because “the acidity of the stomach irritates the esophagus, which can lead to bleeding, then to anemia that hinders growth,” says Andreas Nydegger.
Block the acidity
In this case, it is strongly recommended to consult your pediatrician or family doctor who can carry out investigations and possibly prescribe proton pump inhibitors (PPIs). These drugs “block the production of acidity of gastric juice,” says the pediatrician. The reflux persists, but it does not burn anymore, so it no longer causes pain “. In rare cases, surgery may also be required to partially or completely close the esophagus with a kind of sleeve.
However, this oesophageal reflux disease only concerns “a minority of children”.
Most of the time, after regurgitating, the baby falls asleep quietly and shows no signs of suffering. “Parents should not worry then.” When the child begins to eat solid food, which remains more easily in the stomach, and when this organ is placed in the right position, the case is solved alone.
Practical tips to limit regurgitation
What can be done to limit the regurgitation of his infant when he is subject to a benign gastric reflux? The advice of Andreas Nydegger, head of the Pediatric Gastroenterology, Hepatology and Nutrition Unit at CHUV.
The doctor recommends first to the mother (or to the father when feeding the bottle) to refrain from smoking and, if she is breastfeeding, to avoid drinking coffee. “Nicotine and caffeine have the effect of opening the esophageal sphincter, which facilitates the rise of milk.
As the infant has to drink large amounts of milk, it is also good to “split his meals, giving him a bottle more, which reduces the volume of each meal.” On the other hand, thickening milk, as we often hear it, does not seem useful to the pediatrician. “In this case, the child has to make a bigger effort to drink and has more difficulty digesting. In addition, it adds calories.
He recommends, however, during the digestion phase, to “raise the whole body of the child, not only his head, because gravity keeps the gastric contents in the stomach.”
Should we also avoid clothes and layers that are too tight? “It’s a grandmother’s remedy and its merits are not scientifically proven,” says Andreas Nydegger. But why not? Anything that can reassure parents is helpful.