Emily Blewett, RN, BSN, CLC is a proud mom, NICU Nurse, Certified Moms on Call Baby & Toddler Sleep Consultant + Certified Lactation Counselor. Emily combines the expertise of a nurse, with the care and concern of a mom to partner with you on this wonderful, yet at times confusing and exhausting parenting adventure. Photo by Milana Mia Photography with Kaylee Baggerly

Many babies experience their stomach contents coming back up into their esophagus, known as reflux. If your baby is happy and gaining weight, they are known as our happy spitters and do not need to be on medication for reflux. For our unhappy spitters, they may be diagnosed with gastrointestinal reflux disease (GERD).
GERD is a condition where the contents in the stomach rise up through esophagus AND cause symptoms. Below are some signs and symptoms of GERD:
- Refusal to feed
- Crying, arching their back during feeds
- No weight gain or very slow weight gain
- Vomiting (a forceful flow that shoots out inches)
- Pain with feedings and/or vomiting
Some babies with GERD will be started on medicine, like Zantac or Prilosec. What these medicines do is decrease the acid secretions in their stomach. It is the acid that causes the pain when they spit up. This means your baby will still spit up while on these medicines, but it will be less acidic, so it won’t hurt as much.
Medicine alone will not take away the symptoms of reflux. There are some adjustments that we can make to help these reflux babies feel their best:
In my NICU and lactation experience, classic nipples work best with all babies. Like my friend Mariana says, “Classic never goes out of style.” At Moms on Call, these are the ones that we have seen work most effectively in reducing reflux symptoms, helping with difficult eaters and reducing gas in babies.
When bottle feeding, feed them in an elevated side-lying position. It allows the baby to control the flow of the feeding, which provides a positive feeding experience. With the “crook of the arm” positioning, gravity can have milk flood the baby’s mouth, which leads to gulping, coughing and choking. Studies have shown this position gives babies more feeding endurance. It also leads to increase engagement and volumes of milk.
Did you know feeding is like an aerobic exercise for babies? If feedings go over a certain time or feedings are too close together, it can cause more gas as the digestive system ramps up and also produce more acid secretions, which is what causes the pain. We want feedings under 30 minutes and feedings at least 2 ½ to 3 hours apart. This allows their digestive system to rest, reset and boot.
Do you have questions regarding reflux, gassiness, breastfeeding, bottle feeding, or anything baby or toddler related? Book a personalized consult with me through FaceTime, In-Home, or Email! Check out Personalized Consultations for more information!