"Oh dear, do not worry, all babies sometimes return some milk. If that little stomach is full, well, then the excess simply returns. And that always seems to be much more than it really is. Nothing wrong, do not worry. "
You may have heard similar statements several times by the time you ended up on this page. And maybe they have also reassured you for a while, until you are back in your arms with your hungry baby and have to watch as the whole food comes back. What exactly is that with 'giving back' and can it really do no harm at all?
Reflux, what is that actually?
When the stomach contents flow back to the esophagus you speak of reflux. Your child spits out, (simply), (part of) the food. This is a perfectly normal biological process in digestion. In babies it is more common because the sphincter muscle between esophagus and stomach, which is supposed to keep the stomach contents in the stomach, is still developing. This development usually completes during the first year of life. So almost all children are around their first birthday. Most of them much earlier.
Ordinary reflux or hidden reflux
At normal reflux, the stomach contents return to the mouth of the baby, which then spits it out. At hidden reflux, the stomach contents rise to the esophagus, but then sinks back to the stomach. The process is thus comparable to the regular reflux, but it is more difficult to recognize because the child does not spit, or hardly spits.
As soon as nutrition ends up in the stomach, it mixes with gastric juices. These sour juices are important for the continuation of food digestion. The stomach is protected from these juices by a thick mucous membrane. The esophagus is not. The esophagus can become irritated by frequent contact with the acids from the stomach.
This is the most common. The baby returns (sometimes large amounts) nutrition, but continues to drink, develops well and grows well. Then there is not much to worry about. As said, in most babies the sphincter between esophagus and stomach develops further in the first year. Then the baby will be rid of it. No further treatment is required for this, although the tips later in this article can help.
With complicated reflux, there is more to play than with uncomplicated reflux. The symptoms are also more intense and clearer.
- spits and / or swallows very often
- often has the hiccups
- smells sour
- refuses to drink, drinks very briefly or just wants to drink continuously.
- starts drinking very eagerly, but quickly decays
- coughing, roaring, drooling, hoarse or often sticking out the tongue.
- cries a lot
- sleeps badly
- can sometimes spit blood
This is because the esophagus of the baby has become irritated because stomach acids continue to flow through them. These babies will often not grow sufficiently and the development will (possibly) be delayed.
Uncomplicated or complicated reflux
If you as a parent doubt whether your child suffers from uncomplicated or complicated reflux, it is advisable to seek advice from a doctor. The general practitioner or the consultation office doctor will ask extensive questions to assess which form of reflux is involved and whether further action is needed.
Tips for reflux
In the first instance
- Keep the child upright for half an hour after feeding
- Try to give somewhat smaller amounts of food per day
If this does not help, switch to the following advice
- Try to thicken the food. For example with locust bean gum. The packaging shows exactly how much you need to use
If all of these advice do not help, the chances are that the doctor will propose medication. It will then often be prokinetics, because of this the food will be accelerated to the small intestine, so that it will not get the chance to flow back to the esophagus.
Optionally, gastric acid inhibitors may also be tried after this. Yet research shows that medication often does not help well.
In very rare cases, surgery will be carried out. Fortunately, it almost never comes to that.