Infant Reflux Red Flags

Frequently Asked Questions (FAQs)

Infant spit up can be inconvenient and messy but did you know that it can interefere with typical feeding development, growth, desire to feed and a baby’s ability to gain weight? This FAQ discusses common reflux red flags. Becoming familiar with these red flags will help you determine if it is something to talk to your doctor about. We will also provide clincal management techniques that you can implement now.

Infant Reflux Red Flags

If you can identify with several of these behaviors, your baby may have reflux. It would be best to consult with your doctor.

• Coughing/choking during or after feeding,

• Weight gain issues

• Volume limiting or small frequent feedings

• Seeming desire to feed then refuses

• Sleep feeding/dream feed

• Requires distraction to feed

• Will only feed in one place ( for example: quiet bedroom, dark with a fan on)

• Repeat swallows not associated with feeding

• Hicupping/burping • Arching

• Wants to stand (doesn’t like pressure on their tummy)

• Irritability expecially during or after feeding

• Uncoordinated sucking patterns

What can I do until I can get an appointment? Here are some suggestions that may be helpful:

• Hold your baby upright for a duration of 30 minutes after feeding. Upright does not mean by placing the baby’s head up, but the body must be supported and not slouched (which is often what happens when you place a baby in an infant seat). Be careful to ensure that baby’s back is supported so that there is space between the ribcage and the hips.

• If approved by your doctor, your baby can be inclined 45 degrees while sleeping.

• If approved by your doctor, positioning your baby on the right side may be helpful.

• If your baby takes a pacifier, the stimulated non-nutritive suck and swallow may keep reflux down.

• Avoid rapid changes in positioning after feeding.

• If you must change a diaper after feeding, do so carefully to minimize pressure on the tummy.

• Frequent burps during feeding may be helpful but do not do if baby cries to continue to feed.

• Some babies with reflux like small, frequent meals. If this is the case, definitely consult a Feeding Therapist as there can be long term consequences of this feeding schedule.

• Also make sure that the baby is not swallowing air (areophagia) during feeding. A feeding therapist can train the sucking patterns so as not to swallow air during feeding.

If your baby is experiencing any of these Red Flags a Feeding Evaluation is indicated. Using efficient sucking patterns can minimize air swallowing and reduce the complications of reflux. Your Feeding Therapist can identify specific techniques that support your baby’s feeding and swallowing skills.