Why is reflux more frequent in bottle-fed babies than in breastfed babies, and what can you do to help stop reflux when bottle-feeding? Here’s what parents need to know.
It’s normal for a baby to spit up once in a while. In medical terms, this spitting up is known as reflux or acid reflux. Reflux is caused by an under-developed digestive system.
When the muscle at the top of baby’s stomach (called the lower esophageal sphincter or LES) doesn’t close completely, the stomach’s contents and digestive juices flow back up into the esophagus and throat. This causes baby to spit up.
Babies are more prone to reflux than older children and adults, because a baby's LES muscle is often weak or not completely developed.
Usually, reflux isn’t a major concern---it’s estimated that more than half of babies experience reflux. And usually, babies “outgrow” their reflux between 12 and 18 months, when their LES grows stronger.
But if reflux is especially frequent, if a child doesn’t outgrow their reflux by the age of 2, or if symptoms are severe, this may be the sign of a more serious reflux condition known as GERD (gastroesophageal reflux disease). This article covers how to determine if your baby has GERD, including common GERD symptoms.
Even if baby doesn’t have GERD, reflux can still be uncomfortable for them. It will often cause them to cry and become visibly uncomfortable.
And if your baby is bottle-fed, they’re likely to experience more reflux episodes, and longer reflux episodes, than if they’re breastfed.
Why is reflux more frequent in bottle-fed babies than in breastfed babies, and what can parents and caregivers do to help stop reflux when bottle-feeding? Here’s what parents need to know.
Why is reflux more common in bottle-fed babies?
Breastfed and bottle-fed babies are equally likely to suffer from reflux. However, studies have shown that bottle-fed babies who consume formula tend to experience longer and more frequent reflux episodes than breastfed babies do. This may be because breastmilk is digested more quickly than formula is---around twice as quickly. Since formula takes longer to digest, it’s more likely to escape the stomach when a baby’s LES doesn’t close, and cause reflux.
No matter if you feed baby breastmilk or formula, though, the bottle itself might also be a cause of reflux. Overflow from a bottle can cause your baby to take in too much milk or formula too quickly. It can also cause your baby to take in excessive air along with the milk or formula. The liquid overflow and air over-fill baby’s stomach. And if their stomach is overfilled, baby will be more prone to reflux.
7 Tips To Reduce Reflux in Bottle-Fed Babies
How to reduce reflux in bottle-fed babies? Follow these tips.
- Choose the right bottle. Your baby’s bottle should have a smaller, slow-flow nipple to prevent overfilling of baby’s stomach. It should also have an air valve (sometimes called an anti-colic valve) to prevent the buildup of air bubbles.
- Keep baby upright during and after feeding. Keep their body straight, and keep their head higher than their stomach during feeding. You’ll also want to keep them upright for at least 30 minutes after they eat. This is a great time to talk to, snuggle with, or sing to baby.
- Don’t bounce, play energetically with, or jostle your baby while the milk or formula is settling. Keep baby relatively still in the 30 minutes after feeding.
- Keep baby’s feedings shorter, but more frequent. Avoiding overfeeding is key to reducing the likelihood of reflux. Frequent, shorter feedings are better for reflux-prone babies than longer feedings, as they cause less pressure on the stomach than a large intake of food all at once. If baby still spits up, stop the current feeding and wait a bit before feeding them again.
- Burp baby during and shortly after feedings. This will help reduce the amount of air baby takes in. The Reflux Infants Support Association (RISA) recommends burping baby after every 30-60ml that they drink from a bottle.
- Change baby’s diaper before feedings, so they won’t have to lie down on their back right after feedings.
- When possible, don’t put baby to bed until at least 30 minutes after a feeding. Again, you don’t want baby to lie on their back right after a feeding, but baby needs to sleep on their back to be safe. Of course, waiting to put baby to bed may not make sense in the middle of the night.
Still, after a feeding, try to at least wait 30 minutes before baby’s naptime and before you first put baby to bed for the night. Feeding baby right after they wake up will help with this.
Nearly half of all babies suffering from the more severe GERD have a milk allergy, and many others have a milk intolerance.
If your baby’s reflux worsens with age or develops into GERD, they may have a milk protein allergy or milk protein intolerance. Your baby might also have a soy allergy or soy protein intolerance.
Check the formula’s ingredient list to see if it contains a milk or soy ingredient. Also, if you have recently changed brands and your baby’s reflux suddenly becomes worse, your baby may be sensitive to a new ingredient. Talk to your doctor if you have any allergy or intolerance concerns.
Remember: baby reflux is relatively normal, even though it’s uncomfortable for baby. But if you’re frequently feeding baby out of a bottle, baby is likely to experience reflux more often. Taking the steps above will help you lessen baby reflux, especially if you’re bottle-feeding your baby. Reflux should go away once your baby is 12-18 months old and their LES becomes more mature.
If you have concerns about baby reflux, including those related to allergy, or if you think your baby might have the more severe GERD, please consult your doctor.
All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.
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