Treatments for infant reflux

Sleeping

• Elevating the infant during sleep is imperative. This will help to keep the contents of the stomach from rising up into the esophagus. It is the rising of the acidic contents that causes discomfort and damage.
• Wedges are made to go under the baby's mattress which will help to elevate it. If you have a newborn and they are sharing the bed with you, there is a product called the Snuggle Nest that comes with a wedge to elevate them. There are also sling/wedge combinations on the market made for different ages; one product is called the Tucker Wedge.
• You can elevate the head of the crib or co-sleeper. Elevating the bed 30% should be sufficient.
• Belly and sleeping on the left side can reduce reflux in babies. However, given that back sleep is associated with lowest risk of SIDs, it is best to check with the pediatrician before placing baby to sleep on his belly.

Eating

• Infants who are breast and bottle feeding, do best when eating in a more upright position. For young infants, it can be helpful to breast feed while they are in a sling on the body or positioned at an angle. As the infant gains neck control, try propping them in a sitting position to reach the breast.
• It is recommended to elevate the infant for 20-30 minutes after eating. You can hold them upright or prop them at an angle.
• Try to feed your baby smaller meals, more frequently. For example, if breast feeding, offer one breast every 1.5 hours rather than both breasts every 3 hours.
• There is some belief that reflux is worse in infants that are formula fed. Some find that switching formulas will help with reflux. Try a few brands, including dairy-free formulations to see if symptoms improve.
• Old school pediatricians believe that thickening formula or breast milk in a bottle with rice cereal helps to keep the fluids down. However, it is best to exclusively breast or formula feed for the first 6 months of life. After 6 months, solids can be introduced.

Medication

• Acid blockers are generally effective and relatively harmless. These medications include: H2 Blockers - Cimetidine (Tagamet), Ranitidine(Zantac), Proton Pump Inhibitors - Omeprazole(Prilosec), Lansoprazole(Prevacid) and Prokinetic Agents- Metoclopramide (Reglan ). Zantac is the most commonly prescribed medication. For adults, H2 blockers are sold over the counter; for infants and children, a prescription is required.

• Most peditricians will prescribe medication if all other avenues have been explored. Peditricians are more likely to test out this medication first before running GI tests on infants. (Note that some find that pediatricians are very reluctant to diagnose reflux. If you suspect your baby has it, present a list of symptoms to your pediatrician and be persistent!)