Baby Bottles & Acid Reflux

Breastfeeding is best for any baby, even if they have acid reflux. But parents may have to or choose to bottle feed a baby with acid reflux. There are several things parents and caregivers can do to help ensure the baby can comfortably eat from a bottle and to reduce the amount of pumped breast milk or formula that is regurgitated.

Symptoms

Most babies spit up some after feedings, and it usually is no cause for concern. But for a baby with gastroesophageal reflux disease, often referred to as acid reflux, spitting up is usually more severe and more bothersome. You also may notice your infant cries after feedings, hiccups a lot, chokes while eating and arches her back and neck during or after feeding. Your baby may have trouble gaining weight. These are all common symptoms of acid reflux. Interestingly, some babies with reflux may want to avoid eating because they associate it with pain. Others may seem still hungry after eating, but that's because they want to drink again to soothe the pain.

Not all babies with reflux spit up, though most do. Your baby still may have reflux if he shows several of the same symptoms. This is known as "silent reflux."

Causes

A band of muscle called the lower esophageal sphincter prevents food that has entered the stomach from becoming regurgitated back into the esophagus. In some babies, this muscle is underdeveloped, thus allowing food and stomach acid to spill back into the esophagus. Adults also sometimes experience this sensation -- and call it heartburn.

Feeding

One of the best ways to minimize reflux symptoms is to feed a baby with reflux in a semi-upright position. Gravity will keep the stomach contents down, which is why it's important to keep baby upright after eating as well -- as much as 30 minutes after eating.

Overeating can make reflux worse, so feed your baby smaller amounts of milk or formula more frequently. Symptoms usually are less severe when a baby is fed breast milk -- it's digested more quickly than formula. In either case, Dr. William Sears recommends feeding your baby half as much, twice more often. A stomach that empties more quickly is less likely to allow food to come back up.
Using a bottle with a slow-flowing nipple and burping midway through a bottle can help prevent overeating as well.

Allergies

Babies with severe reflux symptoms often are allergic to cow-milk-based and soy-milk based formulas. Very sensitive babies may even have problems with breast milk if their mother consumes cow milk or soy products. If your baby continues to experience pain after feeding, consider eliminating these products from your baby if breastfeeding or switching to a hypoallergenic formula.

Additional Help

Some babies need medication to help minimize the painful symptoms of reflux. Your child's pediatrician may prescribe medicine that makes the stomach acid in your baby less acidic or help your baby digest food more quickly. Prevacid and Axid are commonly prescribed to babies with reflux.

In very rare cases, surgery may be the best solution.

One thing to keep in mind: Even with medication and modified feeding methods, your child may still spit up. That's OK. Regurgitation from infants is normal; crying from spitting up is not.