If you have a child that had reflux as a baby, you likely were very tired and possibly frustrated for a while until your child “grew out of it”. Your baby’s provider probably told you that reflux is common and to wait it out, or you were given some medication to help alleviate the symptoms that may or may not have helped. Let me stop you there. We tell our patients all the time there is a difference between COMMON and NORMAL. While yes, reflux is common, it is NOT normal! I am going to even push it a step further and tell you that reflux is probably not a diagnosis appropriate for your child, it is likely symptoms of a larger issue. If we can identify the larger issue, we can likely resolve the reflux.
Reflux can be caused by some serious conditions like a pyloric stenosis or even blockage in the intestines. This is often the first thing the pediatrician will look to identify due to the severity of the issue but is not as common as a few other causes. Food intolerance or food allergies could also cause reflux symptoms to be present and may or may not be identified by the pediatrician. Dairy, gluten and soy tend to be the most common that mom will eliminate from her diet if breastfeeding or find a formula free of these ingredients. Again, these things tend to have mixed results with changing the reflux symptoms that baby is having. By no means am I minimizing the seriousness of food allergies, they are very serious and often present but there are usually other symptoms of an allergy aside from reflux.
The most common cause of reflux in the babies I treat is swallowing air. And the most common cause of swallowing air is a tongue tie! I have talked before about the importance of the tongue being able to create a vacuum around the nipple (of the bottle or breast) and without that vacuum air is getting into the baby’s mouth and entering the digestive tract. As an adult, when we swallow air we have the tools necessary to void the air. Unfortunately the baby does not have those same tools therefore the air gets trapped. This leads to the baby spitting up both immediately following the feeding and can also contribute to delayed spit up about an hour or so following a feed. If the air stays trapped, it then has to travel all the way through the digestive tract and you may notice the baby has gas pain. Arching of the back is their way of trying to move the air through them to get more comfortable. The lack of a vacuum can also cause your baby to sound like they are gagging or choking while feeding and frequently come off the nipple.
Tongue ties are starting to be talked about in the medical world more frequently, but are often undiagnosed or misdiagnosed. If any of this sounds like something you and your child have suffered from, please reach out to Dr. Caitlin for help!
I have been trying to find a reason for my 7 month old daughter’s consistent reflux. When she was younger I noticed she didn’t have a strong suck but never thought twice that it was tongue related. Thank you for this information. Do you recommend a pediatrician or pediatric surgeon or ENT?
Seeing the ENT is a great place to start. A pediatric dentist is another great option for an evaluation and revision if necessary.