AAP’s New Advice to Parents of Preemies With Reflux: Don’t Medicate

If you’ve ever struggled with gastroesophageal reflux, commonly known as acid reflux, you know how uncomfortable it can be. Adults can usually just pop an antacid and get on with their day—but for premature babies with GER, it’s not so easy. The American Academy of Pediatrics is now saying that patience—not medication—is the best course of action.

Reflux is when stomach contents come back up into the esophagus—in other words, when a baby occasionally spits up but is otherwise happy and healthy. All it means is that a small muscular valve between the stomach and esophagus isn’t closing as tightly as it should, allowing food and liquid to sometimes slip past.

It’s very normal for babies—in fact, almost all preemies have some GER, the AAP says. But it can also lead to longer hospital stays and possible discomfort, sleep issues and difficulty feeding and breathing.

Treatment options for GER have always been limited, though things like dietary changes, placing baby on the left side or elevating the head have long been thought to reduce the likelihood of GER, and babies with clinically diagnosed GER are often given medication.

But a new AAP report concluded that none of these measures have proven to reduce instances of reflux after all. In fact, there’s emerging evidence that medication can actually do harm, and the Academy is strongly advising that it’s used “sparingly, if at all” in premature babies.

The good news, however, is that the faulty valve is just a muscle. And like all muscles, this valve will become stronger as baby ages, leading to fewer spit-ups. “It is a normal developmental phenomenon that will resolve with maturation,” lead study author Eric Eichenwald, MD, FAAP, says in the report. So the best thing to do for baby reflux is simply wait it out. In the meantime, there’s probably going to be a lot of laundry to do!

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