Reflux impacts 1 in 2 babies in the United States. While it typically resolves itself between 12 to 18 months of age, you do not need to wait to start solids. Our pediatric pros explain how families can help babies with reflux as they begin exploring real food.
Most babies with reflux can start solids as soon as they show all of the signs that they are developmentally ready, which typically happens around 6 months of age. Here is your checklist to get started:
Download the Solid Starts App for help choosing first foods.
Learn how to set up a safe eating environment.
Understand the difference between gagging and choking.
Take an infant rescue course in case of emergencies.
Learn about safe food shapes and sizes.
Consider how solids fits in your feeding routine.
Check out our article, Acid Reflux in Newborns and Babies for how to help younger babies with reflux.
Consider feeding times. Wait a little longer after nursing or bottlefeeding before offering solid food. This way, baby has more time to digest (and is less likely to spit up).
Try smaller, frequent feeds. Offer a little less breast milk or formula, and increase the frequency. This way, baby is less full (and less likely to throw up when exploring solids).
Allow baby to take the lead. Whether offering purees or finger foods, let baby decide to put food in the mouth, which can help avoid or soften feelings of discomfort with eating
Use food teethers. Regularly offer food teethers, which help a sensitive gag reflex and teach their brain how food feels in the mouth and when it is ready to be swallowed.
Go slow with gaggy foods. Wait a few weeks to offer sticky foods (avocado, banana) and foods that scatter in the mouth (rice), which often lead to gagging and spitting up.
Let baby watch you eat. Baby may connect eating with not feeling great, so show them (often!) how satisfying and fun eating can be. This helps encourage baby to explore.
Keep baby upright. Help baby sit upright for 30 minutes after feeding. Lying on their left side can also help. Offering the pacifier after feeding can also help.
Consider an extra burp. If baby seems uncomfortable at the table, take them out of the high chair and try to burp them. Some babies will burp and then return to happily exploring solids.
Contact your doctor if you observe any of the following symptoms:
baby is regularly struggling to drink or refusing food
baby is arching or crying during nursing or bottle feedings
baby is not gaining weight
baby has bloody or green/yellow vomit
baby is inconsolable when crying
baby has trouble breathing
baby is frequently coughing on their spit up, breast milk, or formula
baby will only eat when falling asleep or sleeping (dream feeding)
K. Rappaport, OTR/L, MS, SCFES, IBCLC. Pediatric Feeding/Swallowing Specialist
K. Grenawitzke, OTD, OTR/L, SCFES, IBCLC. Pediatric Feeding/Swallowing Specialist
V. Kalami, MNSP, RD, CSP. Pediatric Dietitian/Nutritionist
R. Ruiz, MD, FAAP, CLC. Pediatric Gastroenterologist
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