Chucky Babies
Reflux? Happy Chucker? Gastro-oesophageal reflux disease (GORD)?
It is typical for babies to bring up some milk after feeds. The immature digestive system might not be quite up to the task of keeping milk in the stomach and sometimes it comes back out again! Babies might look surprised, relieved or not react at all. If they just fed, the milk might look much like it did on the way in but the longer it sits in the stomach, the more digested it will look when it reappears. Some babies will just spit up a little while others might projectile vomit an impressive volume of milk. Babies whose mothers have a strong let-down reflex of fast flow of milk might regularly vomit early in the feed to release the pressure before going back on to continue the feed.
“Happy Chuckers” is a nickname for babies who bring up milk without signs of pain or discomfort. Milk which has sat in the stomach a while might have them screw up their face at the sour taste but they are otherwise unbothered.
Gastro-oesophageal reflux (GOR) is the passage of gastric contents into the oesophagus, often with effortless vomiting, or 'possets'. It is a physiological process that occurs several times a day in healthy infants. Typical reflux in babies seems to gradually increase in the first two months and peaks by around four months and usually disappears by one year. The age this begins tends to coincide with the peak crying period around 6-8 weeks but there is no evidence that babies are experiencing pain or discomfort. It occurs in a round 40% of babies and doesn’t require medication or treatment.
Handle with care
Newborn babies can spend a lot of time being moved from horizontal to vertical and back to horizontal, as parents feed, change and dress them. Babies who experience reflux can be sensitive to such movement immediately after feeding and simply holding them in an upright position against your chest for 20-30 minutes can let the feed settle. Gently moving them into a baby carrier allows them to remain upright while they nap and can reduce vomiting. Only very gentle patting, if any, to help burping - too hard and you might get covered!
Chucky babies are less likely to bring up milk while burping if you position them upright against you. Sitting them on your lap to burp can lead to additional pressure and increase the risk of vomiting.
Breastfeeding chucky babies
If your baby is struggling with a fast flow of milk, they can take in extra air and often appreciate an opportunity to bring it up early in the feed, once the flow eases. They can even come off the breast to catch their breath and pace the feed themselves. Laid-back breastfeeding can allow your baby to feel less overwhelmed by a fast flow and lets them easily come on and off as they need. Other babies, even very new ones, can feed well in the upright Koala hold and cope better with the flow. Generally, breastfeeding positions where the baby’s head is higher than their stomach will keep gravity on their side.
If your baby is gaining weight well, is mostly content after and between feeds and does not appear to experience pain or discomfort when bringing up milk, simple management strategies will help you get through this period. Keep lots of burp cloths handy, dress yourself and baby in simple, easy-wash clothing and be careful around upholstered furniture!
Seek medical advice if concerned
Gastro-oesophageal reflux disease (GORD) is an uncommon medical condition requiring diagnosis by a doctor. It is important not to give babies any medications or make changes to their diet or your own without medical advice. This includes over-the-counter treatments. It is important that more serious medical conditions are ruled out before treating for GORD. Find out more in this Royal Children’s Hospital Fact Sheet or speak to your doctor or nurse.
