Reflux in infants is common, but it’s not benign. Many babies spit up. But persistent, painful, or excessive reflux should be explored — not just medicated.
Meds don’t fix mechanics
Reflux is a symptom, not the root cause. There could be underlying issues, like:
- Positional feeding challenges
- Poor latch or seal (allowing air in)
- Inefficient suck/swallow/breathe coordination
- Structural issues (e.g., high palate, tongue tie)
Even if medication slightly reduces acid, it doesn’t correct poor oral motor patterns, shallow latch, or retained reflexes. In many cases, babies are still vomiting — which leaves parents feeling like they’re the problem.
what’s the problem?
Aside from the obvious issues (weight loss, more money spent on formula, feeling like effort is wasted breastfeeding or pumping, etc.), persistent reflux in infancy can lead to feeding aversions.
If feeding consistently results in pain, babies learn to refuse. This can snowball into chronic picky eating and failure to thrive later on. It’s not about stubbornness — it’s about associative trauma.
…but the pediatrician said…
As a medical professional, I’ll be the first to say it: it’s called a “practice” for a reason. We don’t always know exactly what we’re doing. This also applies to your child’s pediatrician.
Pediatricians don’t always get it right. They might tell you your baby is just “colicky” or a “fussy eater,” they might tell you to change formulas or cut foods out of your diet if breastfeeding, and they may just skip straight to prescribing antacid medications.
In reality, the fix could be as simple as positioning or bottle/nipple changes, release of tethered oral tissues with appropriate pre- and postoperative care, and/or feeding therapy.
what to look for
Of course the number one sign of reflux is excessive spit up or vomiting. However, there are some other things to be aware of.
- If your baby is arching significantly or crying during feeds, reflux is a likely culprit.
- Reflux can also lead to difficulty transitioning to solids, with many children experiencing gagging.
- If your baby makes lots of noise or has significant leakage around the lips when feeding via bottle or breast, the latch and seal are inefficient at best, which can introduce air into the digestive system and contribute to reflux as well.
what you can do
If your baby is showing signs of reflux, there are some steps you can take to deal with the root cause of the issue.
- Seek a feeding evaluation from a trained therapist, especially if your gut says something’s wrong.
- Understand that medications can only do so much, and they don’t treat the underlying issues most of the time.
- Be cautious of switching formulas frequently. If you’ve tried three or more, it might not be the formula. It might be the mechanics.
- Know that it’s not your fault. You are not a bad parent because your baby spits up a lot. You’re doing your best with the information you’re given.