What makes your baby keep spitting?

Reflux in babies: normal or abnormal?

Last Updated on: 20th April 2020, 11:55 am

Speikinder are thriving children. This phrase only applies when babies "spit" after drinking, but otherwise feel good and develop well. Otherwise, reflux can occur in babies - that is, aBackflow of stomach contents into the esophagus or in the mouth - point out pathological causes. Then he should be treated, otherwise there is a risk of long-term consequences. The answer to all the important questions can be found here!

Table of Contents

What is reflux?

At the transition from the esophagus to the stomach there is a muscle fiber ligament that tightly closes the stomach entrance. This "sphincter“Shows a certain rest tension. This creates a pressure barrier between the abdomen and chest, which prevents stomach contents from flowing back into the esophagus. It is only lifted during the act of swallowing so that the esophageal muscles can carry the chyme into the stomach.

In addition, the diaphragm acts like a valve at the point where the esophagus passes through, which only allows the chyme to pass in one direction. In addition, the prevailing pressure in the chest and esophagus ensures that stomach contents remain where they belong: in the stomach. However, this barrier is not insurmountable.

If stomach contents get into the esophagus, medicine calls this gastroesophageal or esophagealReflux. Harmful effects of this process are called (gastroesophageal) Reflux diseaseor GERD (Gastro Esophageal Reflux Disease). Due to the reflux it can, among other things, to heartburn come. A burning pain that runs from the upper abdomen up behind the breastbone to the throat. Because the stomach contents are sour. The mucous membranes of the esophagus and the oropharynx are not prepared for this.

Well, there are different types of reflux in babies: den functional, the pathological and the secondary reflux.

Info: Not every backflow of digested chyme leads to discomfort. In fact, it actually is absolutely normalwhen in babies occasionally Stomach contents come up again. May be associated with hiccups or a little cough. If the swallowed food rises to the top, the little ones spit, cough or vomit. This is not a cause for concern as long as the baby is otherwise fine. Every mother knows this phenomenon and has a burp cloth to hand when she feeds her baby.

Functional reflux in babies

Backflow from the stomach into the esophagus is occasional in all children. Both breast-fed and bottle-fed babies. However, reflux is more common with bottle-fed food, as industrially produced baby food is more difficult to digest and therefore lingers longer in the stomach than breast milk. In addition, she is often given larger quantities.

These most harmless form of reflux falls under the term functional reflux (also: primary reflux or physiological reflux). His causes: The locking mechanism between the esophagus and stomach has to mature first. The esophageal musculature still has a relatively weak internal tension. This loosens the sphincter so that the milk can flow back more easily. And the diaphragm, which normally acts as a valve, may not be fully developed either. Likewise, the structures in the pharynx involved in the act of swallowing. In addition, the child's short esophagus and small stomach only have a small capacity. Result: the babies spit. A process that occurs more frequently in premature babies than in mature children.

In addition, with many babies the The angle between the esophagus and stomach is still very small. As the children grow, the angle also increases. This usually solves the problem with reflux in a natural way.

Overfeeding infants may contribute to their repeated "spitting". Last but not least, the mother's diet and lifestyle, for example alcohol, some components of tobacco smoke and potential allergy triggers (e.g. cow's milk) get into the baby through breast milk.

This functional reflux occurs especially in the first months of life on. After that, its frequency decreases steadily, so that it disappears in most children by the age of one.

Pathological reflux in babies

A pathological (more morbid) Reflux aka reflux disease, however, is when the reflux is so frequent and severe that it causes increased spitting up and other symptoms. For example with children who drink quickly and hastily. Or with a very strong milk ejection reflex. That is, when the breast milk flows so quickly and vigorously that it drips or sprays out. In the case of children fed with the bottle, a hole in the teat that is too large may increase the symptoms. But are particularly common Premature babies or babies with a faulty swallowing act are affected by pathological reflux.

Secondary reflux in babies

A secondary reflux again is the Follow another illness. Such as a neurological disorder, a lung condition (forced exhalation reduces pressure in the chest) or a Diaphragmatic hernia (Gap in the diaphragm with part or all of the stomach moving into the chest cavity).

For example, severe reflux that has occurred since birth with regular gushing vomiting after each meal speaks for a (congenital) Malformation. Such as a pyloric stenosis (narrowing of the stomach outlet), faulty application of the duodenum or oesophagotracheal fistula (abnormal connection between the esophagus and trachea).

Reflux, including episodes of abnormal movements that occur mainly after ingestion of food, speak for one Sandifer Syndrome. This disorder of unknown cause is characterized by an unnatural position of the children's head and neck. And by a strong curvature of the back, so that the head and upper body are convulsively stretched backwards.

Is reflux harmless or dangerous in babies?

A permanent reflux of stomach contents into the esophagus often leads to one Inflammation of the esophagus (Esophagitis). Because the mucous membrane of the esophagus - unlike the gastric mucosa, which is protected by self-produced mucus - does not withstand high acid concentrations. That leads to heartburn and pain. This often leads to scarring, ulcers or bleeding, which can lead to anemia.

The worst complication of reflux is severe shortness of breath, which may lead to Suffocation because the stomach contents that are pushed open obstruct the airways.

However, occasional reflux - as occurs in most infants - is not a cause for concern. Many parents ask themselves: How do you tell the difference between natural "spitting maneuvers" of infants and reflux disease?

When does reflux become dangerous?

For one pathological reflux speak Symptoms how

  • The baby vomits regularly.
  • It flows more than five times milk back on the day.
  • The baby often coughs after feeding (because stomach contents that have got into the airways irritate their mucous membrane) or have excessive respiratory infections (e.g. bronchitis, larynx or pneumonia).
  • The child often cries after breastfeeding.

Such symptoms should be for doctor to lead. He is right away to contact if

  • yourself Blood in the vomit is located.
  • with the child difficulties swallowing occur.
  • the baby often coughs.
  • sign a Anemia show how paleness, weakness, possibly shortness of breath.
  • the baby cries a lot or screaming attacks that cannot be soothed has or seems unhappy.
  • In the child, one as an expression of the pain reaction general restlessness, cramped hands or feet or sweats stand out. Or sleep disorders (lying position promotes acid reflux).
  • the little one Refused to eat (because it is painful), has difficulty drinking or feeding (e.g. delays or interruptions in food intake due to constant screaming or repeated pauses in breathing, hasty drinking).
  • yourself Failure to thrive show, e.g. the child is not gaining weight.

Looking for one Pediatrician? Here you can find recommended paediatricians in Vienna.

How to recognize reflux in babies

In addition to specific questions and a thorough physical examination use different methods. On the basis of the symptoms, for example, initiate examinations such as

  • one Contrast medium swallow: Making of X-rays to find suspected malformations after swallowing a contrast medium paste.
  • a 24h pH metry: Continuous measurement of the pH value in the esophagus via a probe inserted through the nose. It provides information as to whether it is acid reflux and how often it occurs.
  • a Gastroscopyif, for example, there is a suspicion of inflammation of the esophageal mucosa.
  • a Esophageal manometry: Measurement of the pressure conditions in the esophagus using a probe inserted through the mouth. To detect any abnormal movement patterns in the esophagus that prevent the regular passage of food.

What to do with "normal" milk reflux?

If milk flows back into the mouth, it is important that the baby is kept for around 20 minutes after feeding in an upright position remains. And then it is correctly positioned: in the supine position with the upper body raised. Also, it must not be wrapped too tightly or exposed to tobacco smoke.

Tip to prevent the problem at all: Offer smaller, more frequent portions.

What can be done against pathological reflux?

Regardless of the patient's age, if you have reflux disease, you ultimately have to have theirs Track down the cause and treat. The same goes for secondary reflux.

In any case, however, it makes sense to try the following in order to prevent reflux and thus alleviate the symptoms

  • Follow all of the above tips to limit milk backflow.
  • the food something for the child thicken. For example with corn flour or locust bean gum.
  • the Raise the head of the cot a little higher.
  • in consultation with the pediatrician Anti-acidic agentAdminister g. For example, a proton pump inhibitor that neutralizes gastric acid.

Only when all attempts at treatment are unsuccessful, the doctor becomes one Consider antireflux surgery. For example when serious consequences such as failure to thrive threaten.

Home remedies for reflux in babies

Seasoned mothers know they can find three natural remedies for their children's reflux in their kitchen: chamomile tea, apples, and mashed potatoes.

Camomile tea

In addition to essential oils, chamomile flowers contain antispasmodic, anti-inflammatory, wound healing and calming ingredients. Chamomile tea also contains mucilage, which stimulates the immune system and protects against ulcer formation. This is why chamomile tea is suitable for treating heartburn in babies and children. The tea is easy to make: Pour hot water (approx. 150 ml) over a tablespoon of chamomile flowers, let it steep for 5 to 10 minutes and filter the tea through a sieve.

Let the empty baby drink a few sips in the morning. Then it should Lie on your back for 5 minutes. Then drink a few sips of tea again and lie on your side for 5 minutes. Then drink a few sips of tea again and lie on your stomach for 5 minutes. Finally, drink a few more sips of tea and lie on the other side for 5 minutes.

Chamomile tea usually turns out to be well tolerated, but allergic reactions are also possible here. For example as a result of contamination with dog chamomile or a cross allergy (especially with mugwort). In addition, its long-term use is not advisable because of its antispasmodic effect (can lead to relaxation of the biliary tract).


Apples contain pectins, long-chain polysaccharides and, at the same time, fiber that binds water and swells. This creates a gel-like mass, which is presumably a protective effect on the mucous membrane the esophagus has. In addition, pectins thicken the chyme and probably prevent the backflow of chyme. Apart from that, apples are considered Base builderwhich may reduce the acidity of the stomach contents. Will an apple before its consumption peeled and grated, its pectins bind the water better. It also makes the apple easier to digest and makes it easier for the child to feed them spoon by spoon.

However, are suitable Apples only from the 5th month of life - definitely cooked, raw only in small quantities. Apart from that, you have to make sure that the baby can tolerate the apple well. After all, the fruit can too allergic reaction (Rash, diarrhea, difficult breathing) or cause discomfort (e.g. due to fructose intolerance). And you have to be careful that the child doesn't choke on it.

Mashed potatoes

Starchy foods such as mashed potatoes are easily digestible, acid-reducing and stomach-friendly foods. Similar to the pectin already mentioned, they contain branched sugar molecules that bind acid and thus inhibit its backflow. A porridge also has a thick consistency, so that it does not rise as easily as thin-bodied food. Apart from that, mashed potatoes are a great source of food due to its high carbohydrate content much energy, relatively high levels of vital substances and quickly available protein that is needed to build up the body's own protein.

It's easy to prepare: cook the potatoes with their skin on to preserve their nutrients. Then peel and mash, add a little butter if necessary. Let it cool down a bit. Finished. Better to avoid spices so as not to irritate the stomach. Also on cow's milk, since reflux quite often occurs at the same time as one Cow's milk allergy occurs. An occasional mixture with other pureed vegetables (e.g. carrots, broccoli) makes things more varied.

Alternative medicine for reflux in babies

One can also try having the reflux complementary medical methods to meet. For example with homeopathy or Schüßler salts.

homeopathy: In addition to the symptoms, the entire physical and mental state of the child is important for the selection of the right globules. In addition, the circumstances under which the symptoms improve or worsen. The homeopathically trained doctor makes the selection. The globules are best placed between the baby's lower jaw and cheek. And not earlier than 30 minutes after breastfeeding. At the beginning there may be a temporary increase in the symptoms ("initial worsening")

Schuessler salts: Their effect is based on the idea that the cause of symptoms of illness is a lack of certain chemical compounds. This is remedied by giving these - previously potentized and diluted - substances. The globules are to be used like homeopathic remedies.

Preventing reflux in babies - is that possible?

To a certain extent, yes. For example through measures like

  • several small meals instead of a few, extensive ones.
  • a lot of skin contact when breastfeeding to calm the baby. So you usually have more time to drink.
  • if a food allergy is suspected, feed one hypoallergenic baby food.
  • in the presence of the baby Not to smoke, because nicotine relaxes the sphincter and increases reflux.

Doctors judge the benefits of so-called contradictory Reflux pillows (Baby pillow, wedge, health pillow, support pillow). Their wedge shape enables the baby to elevate their upper body by 15 to 30 degrees. This is supposed to prevent stomach acid from flowing back into the esophagus. However, there is no scientific evidence of success compared to lying on your back. There is also evidence that lying on the side of babies is more beneficial than lying on their back. Especially if they are underweight.

Recommended paediatricians in your state:

Gabriela Gerstweiler