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Is fussy baby because of refux?

Why is my baby fussy sometimes during feedings and also after about 1 hour after feedings? She spits up after almost all feedings and may cough and choke during feedings. Is this reflux?

Rita Madden | Other-provider

Rita Madden

Reflux is effortless spitting up, not associated with a burp. Spitting up is common. The question is should it be treated medically? If your baby has forceful spit-ups after every feeding, is miserably fussy and is not gaining weight, then yes, further pediatric evaluation is required.

If the symptoms are not this severe, giving several same-sided nursings in a row may help her feel fuller longer, decrease spit-up and help her sleep more soundly. This will also help you manage an over supply. Also, nurse in a more upright position thus avoiding abdominal pressure. 

Avoid placing her in an infant seat or car seat after feedings. This compresses the stomach, increasing reflux episodes. Avoid using cereal to thicken feedings as this is commonly advised but doesn’t help. If the coughing and choking happens at the beginning of a feeding, it may be associated with a forceful milk ejection reflex (also known as let-down). 

In this case, nurse while laying back more so gravity will counteract the forceful milk flow. You can also get your milk started manually, let your forceful milk spray subside, and then latch your baby on. You may want more help with managing an over supply if these suggestions don’t help. Call one of our lactation consultants for a more specific plan tailored to your situation.

Read more answers by Dr. Madden