Regurgitation is the reflux of stomach contents into the esophagus and out of the mouth. They are very common in infants, who often “spit out” a little milk after a bottle or breastfeed.

Regurgitation occurs effortlessly, suddenly, and the amount of fluid regurgitated is variable. They happen very quickly after eating.

They are very common until the age of 4 to 6 months (more than half of infants occasionally regurgitate).

Regurgitation is frequent and “normal” in young babies, usually not serious. They are due to the fact that their digestive system is still immature. This is particularly the case with the muscle which closes the opening between the esophagus and the stomach. Its role is to prevent stomach contents from flowing back into the esophagus, but it is not yet working well. As a result, the contents of the stomach frequently rise to the mouth, causing regurgitation.

This phenomenon is called gastroesophageal reflux disease (GERD). It is the number one cause of regurgitation and vomiting in infants.

In addition, in infants, the stomach is still undeveloped (it is the size of a walnut at birth). With each feed or bottle, there may therefore be an “overflow” leading to regurgitation, aggravated by the fact that the child swallows air while sucking.

Be careful, GERD does not cause jet vomiting or “bilious” vomiting. If your baby is vomiting repeatedly, in violent, heavy gushes, it is important to seek medical attention quickly. It could be pyloric stenosis, an obstruction of the lower stomach muscle that allows food to pass into the intestine.

This pathology requires urgent treatment.

In the majority of cases, the regurgitations are not serious. They disappear spontaneously around the age of 6 months, and most often disappear before a year, when the baby acquires the sitting position and then standing.

However, some acid regurgitation can damage the esophagus, causing esophagitis. Esophagitis is quite rare, but it causes bothersome symptoms: crying, weight loss (or even medium-term growth retardation), regurgitation with traces of blood, refusal to eat, etc. Drug treatment is then necessary.

Most of the time, it’s okay not to worry. If the baby is gaining weight normally and is not crying excessively, the regurgitation is mild.

Certain measures can help to mitigate them:

• thicken the milk (carob flour, milk enriched with starch or rice, powdered milk for infants “anti-reflux”, etc.)
• avoid unwanted diet changes
• give small volumes rather than large bottles
• avoiding secondhand smoke, which makes symptoms worse

If these measures are not sufficient, it is possible to lay the baby on a mattress inclined at around 30 ° (with good support), on the advice of the doctor.

In cases of GERD complicated by esophagitis, or when the vomiting is too much, drug treatment is often necessary. A pH measurement can be performed to confirm the diagnosis (probe in the stomach).

The treatments most often prescribed are:

• anti-acids (esophageal dressings) to be taken after meals
• “prokinetics” before meals, moderately effective
• proton pump inhibitors (omeprazole) for severe esophagitis

Finally, in the most serious cases, surgery may be advised.