Does my baby have reflux? Why do people keep asking me that? And why do I not seem to care? It is true that Li’l I spits up quite a bit at times. But she seems pretty healthy and happy to me, for one. Also, I seem to remember all the babies spitting up from time to time — Young C and my youngest siblings, too. So I refused to be worried. But then my doctor noticed her hiccuping at her last checkup and asked whether she spits up frequently. I admitted she does spit up, but brushed away the concern, assuring the doctor that she wasn’t losing much. The doc was satisfied with her weight gain (though I noticed that the rate of the gain had seemed to slow down significantly) and overall development and nothing more was said of it.
Still, I was starting to feel like maybe I should at least do some preliminary research into this. Kellymom has a clear break down of the differences between spitting up and Gastroesophegeal Reflux Disease (GERD) which are verified on many other basic websites. The upshot (ha ha ha … get it? upshot?) is that lots of babies spit up (and lots don’t) without any cause for concern. This can be triggered by eating more than their stomach can handle or a too fast and too hard letdown at the breast. (That totally makes sense for me, then.) But unless a baby is gaining poorly and/or seems to be in pain no medical treatment is required. (And there’s LOTS of anecdotal evidence that excessive spitting up is really common.) Burping a baby and keeping them upright and not jiggling them too much after a feed also help. Caffeine intake (oh no!) can exasperate the problem in breastfed babies, so I might have to cut back after all.
This whole spit up versus reflux question is an example of how medical problems surface in our collective awareness and can cause much undue anxiety. Medical conditions can be trendy (eg. autism) and we suddenly see them everywhere. My parents would not have worried about spit up apart from the mess. They’ve never heard of reflux. If a baby wasn’t thriving, then the doctor would ask the appropriate questions and go from there. Nonetheless, we are living in an age of self-diagnosis and hyper-awareness and sometimes that can help ease the pain and discomfort of conditions like reflux earlier.
To that end, you should consider reflux if your baby seems to be in pain while spitting up or just after a feed — sometimes the stomach contents don’t make it all the way up, but still cause discomfort. Be on the lookout for coughing, gagging, hiccuping, and difficulty sleeping. Frequent projectile vomiting is another story altogether — definitely talk to your doctor about that one. Otherwise, keep lots of clothes and blankets on hand and relax.