The evening sunlight streamed through my clinic window, casting long golden streaks across the walls. I leaned back in my chair, finally allowing myself a moment to breathe after a long day. Outside, the sound of laughter from children in the nearby park filtered in. For a brief moment, all was peaceful.
My thoughts drifted to my plans for the evening — a cup of chamomile tea and a good book. But just then, my phone buzzed with a message. It was Anjali.
“Priya, I’m really worried. Ria’s been spitting up after every feed, and sometimes it even comes out of her nose. She cries so much after feeding, and I don’t know what to do. Can I bring her in now?”
The words on the screen pulled me back to reality. I could almost hear the anxiety in Anjali’s voice. Ria, her six-month-old daughter, had been struggling with feeding issues for a while now. I knew this wasn’t just a casual concern — it was a mother’s cry for help.
“Come in now, Anjali. I’ll be here.” I replied instantly.
A Worried Mother and a Crying Baby
When Anjali arrived, her face was drawn with exhaustion. Little Ria was bundled in her arms, her cheeks flushed and wet from tears. The faint smell of milk lingered in the air.
Anjali settled into the chair, cradling Ria, who was fidgeting and whimpering. “Priya, it’s like she’s always uncomfortable. She spits up so much milk after feeding, and sometimes she looks like she’s in pain. Is something wrong with her?” Anjali’s voice cracked with worry.
I gently placed my hand on her shoulder. “You’re doing everything right, Anjali. Let’s take a closer look at what’s going on.”
What Is Gastro-Oesophageal Reflux?
I explained to Anjali, “Reflux is when the milk flows back up from the stomach into the oesophagus — the tube that connects the throat to the stomach. It’s pretty common in babies and can cause them to spit up milk or vomit after feeding.”
Ria’s symptoms fit the description of reflux, a condition that affects nearly half of all infants. “Sometimes, babies have mild reflux after burping, which is called posseting. It’s usually harmless. But if it’s severe, it can cause a lot of discomfort.”
Anjali nodded, her brows furrowed. “She cries so much after feeding, Priya. It breaks my heart.”
Symptoms of Reflux to Watch For
I listed some common signs of reflux so Anjali could understand Ria’s condition better:
- Frequent spitting up or vomiting after feeding.
- Crying or discomfort during or after feeds.
- Regurgitating milk through the nose.
- Arching of the back during feeds, indicating discomfort.
- Distress after feeding (fussy or irritable behavior).
- Poor weight gain in some cases.
Anjali sighed. “That sounds like Ria exactly. Sometimes, she even refuses to feed.”
Understanding the Risks of Reflux
“Reflux usually gets better as babies grow,” I reassured her. “But sometimes, it can lead to complications, especially if the reflux is severe.”
I told her about some risks to be aware of:
- Failure to thrive due to poor feeding and weight gain.
- Peptic oesophagitis: Inflammation of the oesophagus caused by acidic stomach contents.
- Peptic stricture: Narrowing of the oesophagus.
- Lung problems if milk and acid get into the lungs, potentially causing aspiration pneumonia.
“Don’t panic,” I said gently. “Ria doesn’t show signs of these complications, but it’s good to know what to watch for.”
Treatment Options: Keeping It Simple
“Most cases of reflux don’t need medical treatment,” I explained. “But there are things you can do at home to make Ria more comfortable.”
Simple Home Measures
- Avoid excessive handling after feeds.
- Posture matters: Hold her in a slightly upright position (about 20 to 30 degrees) after feeding.
- Don’t lay her flat right after she feeds — wait at least 30 minutes.
- Left-side sleeping: Place her on her left side to sleep, but only if advised by a doctor.
Anjali took a deep breath. “I can try those things. What about feeding?”
Feeding Tips for Babies with Reflux
“Feeding adjustments can help a lot,” I said.
- Small, frequent feeds: Instead of large meals, give Ria smaller amounts more often.
- Avoid overfeeding: Pay attention to her cues for fullness.
- Thickened feeds: Sometimes adding a thickener to formula helps reduce reflux. There are also pre-thickened formulas like Enfamil AR and S26 AR.
Anjali looked relieved. “That sounds manageable.”
When to Worry
I reassured her that reflux usually improves with time. “Most babies outgrow reflux by 12 to 18 months. But if Ria shows any of these symptoms, come see me right away:”
- Difficulty swallowing or choking.
- Green or blood-stained vomit.
- Projectile vomiting.
- Distress during feeds.
- Poor weight gain or weight loss.
- Persistent irritability or refusal to eat.
Medication and When to See a Specialist
“For severe cases, there are medications that can help,” I said. “Antacids, H2 receptor blockers, or proton pump inhibitors can reduce stomach acid. But we’ll only consider those if Ria doesn’t improve with home measures.”
“If things don’t get better,” I continued, “we might need to refer her to a specialist for tests like an X-ray or endoscopy.”
Wrapping Up with Hope
Anjali’s shoulders relaxed. She looked down at Ria, who had finally drifted off to sleep in her arms.
“Thank you, Priya,” she whispered. “It helps so much just knowing there’s a plan.”
I smiled. “You’re doing an amazing job, Anjali. Remember, reflux is common and usually resolves on its own. You’re not alone in this.”
As they left the clinic, I felt a familiar warmth in my chest. Moments like these — helping a friend find hope and comfort — remind me why I chose this path. Sometimes, a little reassurance can go a long way in healing both a baby and a worried mother’s heart.
Key Takeaways for Parents
- Reflux is common in infants and usually improves by 12 to 18 months.
- Simple measures like upright positioning and small, frequent feeds can help.
- Watch for warning signs like projectile vomiting, poor weight gain, or choking.
- Medication is reserved for severe cases.
Reassurance and support can make all the difference for a parent navigating their child’s discomfort.