Written by
Dr. Harvey Karp
For many years, pediatricians have wondered if colic might actually be a burning pain caused by acid reflux in babies (when stomach acid squirts back up the wrong way also known as gastroesophageal reflux disease, or GERD). One book even trumpeted it as “the cause of all colic.” But hundreds of millions of dollars spent on baby antacid medicine (and big-pharma ad campaigns) have been wasted. It’s now proven that GERD rarely causes colic.
Australian doctors examined 24 babies who were so irritable they had to be hospitalized (all under 3 months of age). Each was checked for acid reflux, but only one had it. In fact, studies now show that even babies who do have severe reflux usually have no pain. Out of 219 babies hospitalized because of severe reflux, 33% had excessive vomiting and 30% were failing to gain weight but few had just excessive crying.
A University of Pittsburgh study confirmed that acid reflux medicine makes no difference for most babies with colic. Doctors caring for 162 infants with marked crying after eating gave half the babies a powerful antacid; the rest got a placebo. What happened? Fifty percent of babies got better on the medicine…but 50% got better on the placebo, too.
In truth, all babies have reflux; we just call it by a different name: spitting up. There is a muscle at the bottom of the esophagus that keeps stomach juice from flowing back up to the mouth. For the first 6 months it is pretty weak, so babies often burp up a smidge of their last meal…mixed with a bit of stomach acid. And, some barf huge amounts, with no crying at all. Doctors call them happy spitters and suggest just burping them better and not overfeeding. For these families, the biggest problems caused by acid reflux in infants are milk stains on clothes and sofas.
Despite years of mounting evidence, 82% of pediatricians are still fooled into overprescribing acid suppression medicines. (Most of these medicines are not even FDA approved for infants under 1 year of age.) Frustrated doctors try to calm frustrated parents by giving out hundreds of thousands of antacid prescriptions every year.
Not only is this medicine unnecessary, it may be harmful! Stomach acid is an early line of defense against the bacteria your baby sucks off their fingers and lips and swallows every day. Studies show that antacid drugs allow bad bacteria to grow in the stomach and may raise the risk for pneumonia and gastroenteritis. And one type of antacid even had to be pulled from the market because it was found to cause sudden death.
When should you suspect that your baby has a reflux problem? (Gastroesophageal reflux disease, or GERD, is the name of the condition that involves frequent episodes of GER.) Only if you see these telltale signs:
Acid reflux in babies typically begin between weeks 2 and 4. Newborn acid reflux tends to peak around 4 months, and the symptoms finally subside around 7 months. Keep in mind that every baby is different and the acid reflux can last shorter or longer depending on your baby.
When babies are suffering from acid reflux they prefer to be held upright. Fussy behavior from reflux can occur all day, rather than just at night. However, if acid reflux is uncomfortable it can cause restlessness in your baby and difficulty sleeping at night.
GERD and acid reflux in infants can be treated in the following ways:
Note: So, even if your baby has improved on acid reflux medicine…ask your doctor about trying them off it for a few days, to see if the medicine is really necessary.
Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider. Breastmilk is the best source of nutrition for babies. It is important that, in preparation for and during breastfeeding, mothers eat a healthy, balanced diet. Combined breast- and bottle-feeding in the first weeks of life may reduce the supply of a mother's breastmilk and reversing the decision not to breastfeed is difficult. If you do decide to use infant formula, you should follow instructions carefully.
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