There is literally an OCEAN of baby reflux treatments and it can be difficult to make a choice but we'd like to suggest you first decide what speaks to your values as a parent, get fully informed with as much information as possible, don't be afraid to try something else if what you're currently doing isn't working and if you find something that works, stick with it!
The goal should be: Get your baby 100% painful symptoms free and keep them that way until they outgrow reflux, which is typically within 12 to 18 months.
We believe in treating with very safe medications, which can include
nutritional balancing and even coaching from professionals that have
been through the same experience and know what to do. But every baby is different and what worked for someone else's baby isn't always what will work for yours. This is where connecting with an army of moms in our Facebook group can be super helpful and we support all choices made as your baby reflux treatments.
Antacids are chemical compounds that are able to raise the stomachs pH to above 3.5 pH in approximately 10 minutes and are good for intermittent reflux episodes that don't require long term control of acid. More on Antacids.
When acid reflux is present there is a histamine release. This is a natural reaction to the acid exposure. An antihistamine can block some of the histamine but does nothing for the acid production that is causing the histamine release. This is histamine type 1. Histamine type 2 is involved in acid production and H2 blockers may be used to partially block acid.
Chiropractic for babies: During natural child birth many doctors, because they're right handed, tend to rotate the child's head to the right and that can cause a subluxation creating an impingement of the vagas nerve. That nerve runs all the way down to the diaphragm. Chiropractors suggest that this a partial cause of the reflux symptoms. When choosing a Chiropractor make sure they are part of the ICA, the ACA or ICPA Pediatric councils.
Erythromycin and other pro-motility medications conduct stomach emptying by stimulating a motility receptor (called Motilin). Some other names include Bethanechol Erythromycin (Eryped®), Doperidone, Metoclopramide (Reglan®) Read more on Erythromycin here. There is a BLACK BOX warning on Reglan which was originally used to treat schizophrenia. You should read both the below articles prior to using Reglan as an attempt to treat your baby's reflux.
Gas drops SIMETHICONE (sye-meth-i-kone) break up gas bubbles in the
digestive system, mainly the stomach. They have no acid production
qualities but these can be good to use with other acid production
control products. They also have little to no side effects. Some brand
names include: Little Tummys®, Mylicon® and others.
Gripe water is an herbal based (Ginger, Dill, Fennel, Chamomile and other herbs) home remedy and does contain sodium bicarbonate in most cases, which can aid in neutralizing stomach acid but can also cause gas depending on amount given. It also contains alcohol which can irritate tissue which may be already damaged from acid. There is also no known negative, mild or serious, side effects. Some brands include: Babies and Bliss®, Mommy's Bliss®, Colic Calm®, Little Remedies®,Woodwards®.
H2 Blockers can be very helpful for short term sporadic reflux episodes that last less then 2 to 3 weeks because tolerance is rapidly developed. Usually within 4-6 weeks. It is typically not recommended for use longer than 2 weeks by most doctors, for that reason. Here's a non-bias article that explains why. Some examples of what is available on the market today are: Ranitidine (Zantac®), Famotidine (Pepcid®), Cimetidine (Tagament®), Nizatidine (Axid®). Read More Here On The H2 Blockers
Lip & tongue tie revisions is the surgical removal of the skin connecting either the lip or the tongue (the frenulum) and is painful and permanently alters the natural anatomy of your child’s mouth. The reasoning is the frenulum prevents the ability to latch when breast feeding. Although some have seen a reduction in symptoms, the number of infants that show signs of relief are less than 1/2 of a percent. Examples of when this procedure would be beneficial is on this page.
Nissen Fundoplication is a surgery done on infants, children and adults. The larger nodule of the stomach is wrapped around the esophagus and sewn together to create tension around the esophagus to keep the stomach contents and in some cases the acid that's refluxing up into the throat, down in the stomach. Studies have shown, patients are often back on PPIs in a year or have too tight of a wrap making it hard for food to pass into the stomach. More Nissen Fundoplication information click here.
Nat Phos 6x is known to contain a small amount of sodium phosphate which can have antacid qualities. It is indicated for both gas, indigestion and joint pain. Although this may be a good homeopathic option for mild episodes of acid reflux it may not be effective for long term or moderate to severe baby reflux treatments. More on this subject here.
Infant Probiotics can be a very valuable part of baby reflux treatment and when choosing your infant probiotic it's essential that it include a strain called Bifidobacterium infantis (B. Infantis - the abbreviated name for Bifidobaceterium infantis). Gut health can greatly reduce your bodies need to produce too much acid and although getting the acid production under control probiotics are a great way to keep it undercontrol. More information on Probiotics and infant acid reflux.
Proton Pump Inhibitors (PPI) work at the site of the parietal cell which is where acid production occurs. It's clear that we endorse the use of PPIs as a baby reflux treatment option but success is highly dependent on the dose and how many times per day you give the PPI for it to be an effective treatment. That's where the Maci Kids study comes in.
Using a Specialty Formula or Hypo-Allergenic baby formula is required many times when the baby has MSPI (Milk, Soy, Protein Intolerance) or FPIES (Food Protein-Induced Enterocolitis). It's super important to work with a doctor which can sometimes help getting the cost of these expensive formula options covered by insurance but also working with a infant GERD nutritionist or coach to ensure you're making the right formula choices as one of your baby reflux treatments. This is a great resource for baby formulas.
TED or Total Elimination Diets can be very helpful as part of your reflux treatment plan. Sometimes a simple fix like a change of diet for you while breast feeding can work wonders but should be done with the guidance of a qualified nutritionist or coach so you get the nutrition you need and your baby needs during breast feeding. Here's a list of low acidic foods and perhaps reading this page on MSPI or FPIES is helpful as well.
Thickening Formula - Is it helping or making things more difficult for my baby? That
is a very good question. Most of the time thickening is offered in an
effort to reduce the movement of stomach contents into the esophagus by
making the food thicker and more difficult to spit up. However, if your
baby is already having difficulty digesting food for other reasons, this
can cause more acid production as the body attempts to break down food. Read the article on this page for more in depth information about thickening formulas.
Or the brand name Carafate® is an aluminum containing sticky sugar that
acts as an ulcer adherent paste, binding to open sores in the lining of
the esophagus, stomach and small intestine. Think of it as a Band-Aide®
specifically for ulcers.
Sucralfate offers local protection for ulcers and requires the presence of stomach acid to turn it into a paste that will bind to the ulcer. The paste helps promote healing by preventing more acid from seeping into the ulcer. It comes in tablet form or as a suspension but is only provided with a prescription.
Since sucralfate requires stomach acid to reach an active state it cannot be used with any Antacids, H2 blockers or PPIs. It is effective in treating ulcers resulting from reflux but cannot control infant acid reflux itself. It has few side effects because it acts topically and is minimally absorbed into the bloodstream.