Gastroesophageal reflux (GER) in newborns and diet mother

It is common for babies to spit up some milk after the feeding. However, in some cases this goes hand in hand with other symptoms like: restlessness, fussiness, refusing to eat, choking, gagging and hiccups. In the first 2 months of life, about 70-85% of the infants have some mild gastroesophageal reflux (GER) symptoms (Czinn and Blanchard, 2013). The good news is, in 95% of the cases these symptoms resolve within the 1st year. However, what to do when symptoms get worse over time? And affect the baby’s sleep pattern and weight? Does the mother's diet play a role?

Cow milk protein allergy

Let’s start with diet since in Ayurveda diet is the foundation of our health. In about 42-58% of the newborns the reflux symptoms overlap with a cow’s milk protein allergy (Czinn and Blanchard, 2013). This doesn’t just count for babies who receive formula feeding. This means as well, when you are breastfeeding that the cow milk proteins you are ingesting, can cause an allergic reaction in your newborn. After 2-4 weeks eliminating cow’s milk protein from the diet the symptoms significantly decrease (Czinn and Blanchard, 2013).

Other types of dietary sensitivities

Persian medicine has some other dietary solutions for the elimination of GER symptoms in newborns. The following dietary guidelines are recommended:

• Avoid cold foods in general but especially salads

• Avoid yogurt or pickles with food

• Eat slow and chew food thoroughly

• Avoid drinking during and after a meal

• Avoid eating (snacks) when your stomach is full

An Iranian study among 84 breastfeeding moms showed that these dietary changes especially lead to less episodes of hiccups and irritability/fussiness. Also, the frequency and severity of all the GER symptoms decreased significantly among the women who changed their diet (Jahangir et al., 2020). In addition, their babies would gain more weight and were longer than the babies in the control group.

Ayurveda and GER

Interestingly, Persian medicine and Ayurveda have some protocols in common. Ayurveda focuses in the first place on balancing the doshas, Vata, Pitta and Kapha. Eating according to your constitution is therefore the starting point. Afterwards, you can start focusing on balancing Pitta dosha, as these symptoms are mainly caused by an aggravation of it. In general this means to avoid:

• Fermented foods (including alcohol and cheese)

• Very salty, sour and pungent foods

• Deep fried food

• Carbonated drinks

• Coffee

• Chocolate

Probiotics

In addition to some dietary changes, you can consider giving your newborn probiotics. A placebo-controlled randomized clinical trial among 589 infants showed that giving probiotics with the L reuteri DSM strain for 90 days reduced the crying time by 33 minutes a day (from 71 minutes to 38 min), the amount of regurgitations reduced by 3.7 times a day and the number of evacuation of their stools went up by .8 times (Indrio et al., 2014). It is plausible that ingestion of probiotics by the mother will also reduce the symptoms of GER in the infant.

In short, if you want your newborn’s GER symptoms to reduce, cutting down on cow’s milk for a while is in 50% of the cases effective. Additionally, the likeability for dissipation of the symptoms increases by following the Persian medicine protocol. From an Ayurvedic perspective, it is mainly helpful to cut down on Pitta aggravating foods, like fermented and deep fried foods. Lastly, probiotics for the newborn reduce most of the symptoms as well.