In my years of working with babies a pattern I have seen emerge is the prescription of reflux medication to babies. I am not sure about you but it strikes me as a strange practice. Even among pediatricians there is concern for the greater than 7 fold increase in acid reflux medication prescriptions to babies from 1999-2004. We will discuss what is normal and what is not when it comes to spitting up. In addition we will look at the top ways to prevent your baby from spitting up.
GER VS GERD
First lets discuss a fascinating article written Dr. Eric Hassall a pediatric gastro-enterologist http://www.jpeds.com/article/S0022-3476(11)00897-3/fulltext. He is a specialist in disorders of the everything from the stomach to colon for kids. He differentiates between GER (gastroesophageal reflux) and GERD (gastroesophageal reflux disease). He says GER is common in infants for several reasons. One they take in a lot of liquid (breastmilk or formula) for their size compared to an adult. He also notes that anatomically infants have a relatively short esophagus so some of that liquid comes back up and out. As I said earlier he is deeply concerned with the huge increase in prescriptions of reflux medications to infants under 1 year old. There was approximately 1 million infants in the study database and about 5,000 of them had taken this medication in their first year of life. About half of this 5,000 were under 4 months of age. He states “this change in practice has come about for several reasons, none based in medical science” Yikes! Important note studies done have shown that these medications are no better than placebo in infants.
“ACID REFLUX”
As Dr Hassall stated before the increased rates of prescription are not based on medical science. One reason he states for the increase in prescriptions…..advertising. Before mid 1990’s there was more strict rules about how pharmaceutical companies could advertise directly to consumers. After the mid 90’s the rules were relaxed and the advertising increased dramatically. The advertising agencies came up with the term “acid reflux” as a blanket term for reflux. So in 2005 the gross sales for Proton Pump Inhibitors (a type of “acid reflux” medication) was $13 billion.
Consumers see the advertising, self diagnose “acid reflux” and then ask for the reflux medication. This term became so embedded that parents and doctors started diagnosing babies with “acid reflux”. Even though it is quite common and normal for babies to spit up.
So we have advertisers create a term. Which created increased demand which led to more babies taking reflux medication.
THE DARK SIDE OF INCREASED MEDICATION USAGE
As with everything in medicine there is benefits and risks. In this case the risks far
outweigh the benefits. The high acid level in our stomach has many important benefits for us. Mainly it helps protect us against infection and absorb essential nutrients.
Here is a list of negative effects that can happen in infants using acid reflux medications
Increase in community acquired pneumonia
Acute inflammation of the stomach
Imbalance of our gut flora resulting in candida overgrowth
In adults they have found these medications result in
Vitamin B12 deficiency
Magnesium Deficiency
Poor absorption of calcium
I am sure the ones that apply to adults would apply to babies as well.
WHAT TO DO THEN?
Since acid lowering medications aren’t the answer what are some things that can be done to help your baby who is spitting up frequently.
Let gravity help things stay in your baby's stomach. Meaning try to feed them in an upright position as much as possible
Burp your baby when they take a break from feeding to allow air to escape from their stomach and make more room for food
Keep your baby more still after a feeding so their stomach can process the food. Excessive movement can cause the stomach to spill its contents.
Have your baby checked by a pediatric Chiropractor
Yes you read the last one correctly. The first three lines I am not sharing anything else you can not read all over the internet. The last line I know is a surprise for some of you. Yes spinal problems which are common in babies can cause them to spit up a lot more. Why?
STRESS
How did your stomach feel when you were about to go on stage to give a presentation? Was it calm or was that lunch you ate 1 hour earlier threatening to come back up? It is fascinating how much stress can affect us? I remember when I was in Chiropractic school interviewing a woman who was pretending to be a patient. I was sweating so much that it looked like I just got out of the shower. Thankfully that doesn't happen anymore otherwise......
So why does a baby have stress? There life is great. They eat, sleep, poop and make some noise on occasion. Yet as I have mentioned in a previous post the birth process can be really hard on them. https://www.brightstartchiropractic.com/blog/why-does-my-baby-need-a-baby-chiropractor The birth process causes problems in the spine which affects the nerve system. Basically it causes stress and makes the whole digestive system go haywire. Just like it does when you are really stressed about something.
ANOTHER OPTION FOR YOUR SPITTING UP BABY
The signs that a spinal problem could be the cause are
Your baby sleeps less than 2 hours between feedings
Your baby has a preferred sleeping position
Your baby cries if you change their preferred sleeping position
Your baby will only sleep held upright or semi reclined in your arms
Your baby cries if you try to put them on their back
Your baby is generally fussy
Your baby prefers eating from one breast over the other
Your baby keeps their head tilted a majority of the time
These are things to consider when your baby is spitting up. Now you have another option to consider if your baby is spitting up a lot.