This list has been updated each year for the past three years, but the core tips and tasks have remained the same.

I started this site on the premise that although every situation is different, there are common threads that bind families and caregivers managing reflux, colic and related issues in their homes.  
​
Check out below and let me know what we're missing here!

1. Take a Deep Breath: You're not alone. Nearly half of all babies do some spitting up or show some forms of reflux. You can tackle this!
2. Schedule (SAFE) Sleep: Chances are your baby will not find rest and comfort easily. This calls for a critical focus on safe sleep awareness and practice. This also means you'll have to work extra hard to take care of yourself. Find a friend to help you consistently have the chance to sleep, whether several hours overnight or naps during the day. Sleep and sleep training for your little one is a different challenge altogether. 
3. Get Confidence in Your Doc: You need to establish a good and confident relationship with your doctor. All doctors may be different, but you need to the find the one that's right for you and knows you and your baby. When in doubt, search a new one out. Check out and/or rule out issues like silent reflux, tongue-tie and lip-tie, MSPI and other allergies, teething or illness, and more. 
4. Medicate or Wait? At some point, either sooner or later, the question of medication will come up. The more you are educated and in-tune with your baby (and highly confident in your doctor - see #3) you'll be prepared to stand behind your choice.
5. Watch Their Weight: It will be the major measuring stick to the spit up severity - no matter how much you think is staying in, what will matter is if the baby is gaining weight and thriving.
6. Think Vertical: To keep the spit up down, you'll find benefits to keeping your baby upright during feedings. Take advantage of this time to bond with baby as you hold them close. When it's time for naps or sleeping, follow the safe sleep guidelines. 
7. Talk it Out: Talk to other moms and caregivers, past and present, and you'll soon find many others in your situation. It may be only revealed if you start the conversation, so don't hold your feelings in. 
8. Tricks of The Trade: Everyone has their own tricks and the Internet is full of advice from other moms and caregivers. Try, try, try to see what works for your and your baby. Stay on top of news and research.
9. Tools of the Trade: Burp cloths. In addition to burp cloths, which I never had one less than an arm's reach, there's also a whole market of products developed just for these types of conditions, such as gripe water. Did I mention burp cloths?
   
10. This Spit Shall Pass: Some sources say babies can spit up well into their second year, and it still could be normal. If it doesn't seem to subside, you and your doctor will move to find the cause and set a new course for your child. Hang in there.
    

BONUS TIP: Pay it forward. Though we're all in this together, every single situation is unique. From preemies to older to children, and from one solution to the next. We can all benefit from the sense of community created when families open up and share their stories. 

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Editors note: This post originally appeared in 2015 on the Down With Spitup blog. More resources and information has been added throughout the years.

Read this first!

First off, I would recommend reading this post before you Google image search these terms. It will better prepare for what you need to see but maybe don't want to see. If I'm too late, my apologies!

Secondly, I've seen a lot of chatter (and/or moms going quite mad) over the past few years specific to this.

Either they didn't notice, didn't know of connections to their infant's issues, or simply didn't even know it was "a thing." Count me in to this group.

​Once educated the conversations can change dramatically with your docs, lactation consultants, etc. Read on for info and updated resources.

And don't beat yourself up if some answers are literally right under their nose!

What is tongue-tie or lip-tie? 

I found these simple explanations on the Australian Breastfeeding Association site:

"Tongue-tie occurs when the thin piece of skin under the baby's tongue (the lingual frenulum) is very short and restricts the movement of the tongue. The tongue is not free or mobile enough for the baby to attach properly to the breast."

&

"An upper lip-tie is where a piece of skin under the baby’s upper lip (the labial frenulum) is very short or thick and is pinned too tightly to the upper gum. This can restrict movement of the upper lip preventing it from being able to flange or ‘pull out’."

There's also information online regarding lower lip ties, and the issues that may be involved. 

As you can imagine, both conditions can cause challenges in breastfeeding and proper feeding overall.

The reflux and colic connection

What's more, according to MommyPotamus' EPIC POST on Diagnosing Tongue and Lip Ties, "Unfortunately, the symptoms are often misdiagnosed as other conditions like colic, reflux, and failure to thrive because many pediatricians and lactation do not know how to properly identify them." This article goes into detail on diagnosing this condition, including an incredible list of symptoms and graphics and photos to review. 

And according to the Dr. Gharheri site dedicated to these issues, "babies who have tongue-tie and lip-tie commonly take in significant amounts of air." The article continues, "Sometimes, an audible clicking or gulping sound is heard. Parents can often feel or hear air in their child's stomach, and burping doesn't always work to get it out. This air can act as propellant, causing silent reflux, spitting up or even projectile vomiting." You can view the full article here.

Babies that are bottle-fed can have the same issues: taking in too much air because of an inadequate seal. I exclusively used Dr. Brown's for both of my children to try and remedy the extra air.

So, what's the deal?

Fortunately, or unfortunately, this is one of those gut parenting situations that I talk about so frequently. You or your doctor might come to the conclusion that your little one indeed has a tie, and can discuss courses of treatment.

According to The Leaky Boob's "Basics of Tongue and Lip-tied Related Issues: Assessment and Treatment" the 
frenotomy/frenectomy is a relatively routine procedure done by a variety of physicians, with minimal risks and quick recovery involved. However, as the article states, there is a risk of reattachment.

Whether this will correct or lessen your child's reflux and colic symptoms will be unique to your situation, but as in all cases, the more factors you can eliminate as the source will help you and child get closer to finding the right solutions for you.

My advice to start is to simply to open their mouth, look closely and then blow up Google with some comparative image searches. 

There's so much you're caught up in as a new parent, or while balancing multiple kids and babies, sometimes the answers are right under your (their) nose. 

• La Leche League International - https://www.llli.org/breastfeeding-info/tongue-lip-ties/
• Feed The Baby: Tongue-Tie & Lip-Tie: http://feedthebabyllc.com/tongue-and-lip-tie/
• Tonguetie.net Photo Gallery: http://tonguetie.net/photo-gallery/ 
• KellyMom Resource Page (updated): http://kellymom.com/health/baby-health/bfhelp-tonguetie/ 
• Infantreflux.org: http://www.infantreflux.org/tonguelip-tie/ 

​

This post title could've been "holding on by a thread." That's how many parents and caregivers feel when it comes to making their newborn or infant comfortable amidst reflux and related issues. 

While the primary advice is to try and keep your baby upright, the actions are easier said than done, when the discomfort reigns and sometimes around the clock.

Below are few tips I found in my own experience and sources around the web:

Straight up holding
For the first six weeks I gave new meaning to baby wearing, as in holding upright and on my chest (and others). It was why I wore a white sweatshirt for that same time too as you couldn't see all the spit up daily. Tough on the inconvenience meter, and my back eventually, but also necessary in my case.

This "Reflux Relief" list on Breastfeeding Quest gives a variety of options for holding and positioning. Parents.com has bottle feeding best positions post as well. 

Spoiler alert: the constant companionship didn't spoil the child. He just told me the other day that he needed his space while he played his legos. 

Baby wearing
I tried with both of my sons the wraps and slings for actual baby wearing but failed both times. Both kids screamed until they were out Tara Greaves, author and former reflux parent blogger at https://aftertheraincomessunshine.com, shared earlier on this site that she "went through three different ones before going back to the first...it was the only way I got anything done in those early months when she needed to be held upright all the time."

See more on InfantReflux.org's Infant Reflux and Babywearing: A Happy Coexistence 

Swaddling?
Pure physics and logic would say that nothing tight (clothing, diapers, etc.) around the baby and its core would be smart in these cases. However, swaddling, aka "the fourth trimester," is typically recommend to try with reflux babies because it creates a soothing effect against the agitation that can make reflux worse. In my case, finding swaddle swagger was about all I could do to catch a break.

Check out this post on Ergo baby from sleep consultant Rebecca Michi "Swaddling our Newborns," and specifically the part on reflux help.



What did you do to keep holding on, and more importantly, would you have done anything differently?

Pain into purpose. There is power and healing in sharing one's struggles, and no better channel for us than through parenting blogs.

While I'm never surprised when a mom or dad pours their heart out online about life with a reflux baby or child, I am always inspired by their courage. Why? Because the ugliness of the situation comes with strong doses of guilt and reality. 

We are all too conscious of the fact that we must be grateful to have a baby in our arms, when so many do not. We can't complain about sleeplessness or laundry, when there are far too many families dealing with serious issues, including the most severe cases of infant reflux. 

Then there's the feeling of helplessness and being out of control. We can't find the relief or remedy to help our child who is helpless themselves, and literally sit and suffer in our own way while time passes.

If you've landed here at a point of desperation, please check out the accounts below, for even a bit of a break from the anguish. Save the guilt for another day and realize you aren't alone. 

Tears, Pain and Suffering - A Newborn with Reflux
http://www.adventureswithj.co.uk/adventures-of-parenting/reflux-newborn/
(@100awj)

How my baby's reflux affected my whole family
https://reflux.support/how-my-babys-reflux-affected-my-whole-family/
(@babyreflux)

Dealing with Colic and Reflux in babies
http://www.arthurwears.com/2015/09/dealing-with-colic-and-reflux-in-babies.html
(@arthurwears)

When your baby has reflux
http://unfilteredmami.com/2016/02/when-your-baby-has-acid-reflux/
(@unfilteredmami)

Reflux mums will know
http://ghostwritermummy.co.uk/2015/07/15/reflux-mums-will-know/
(@ghostwritermumm)

DownWithSpitUp on Fox8News, Cleveland Ohio
http://www.downwithspitup.com/spit-up-blog/christina-schmitz-talks-car-seat-dangers-and-the-reflux-connection-with-fox-8-cleveland
​

My journey may have ended, but at any given moment, the story is just starting for a new family. Learn more about DownWithSpitUp.com.

​

If you’ve landed here looking for advice on the best medicines for your baby’s reflux, I’m sorry, you won’t find much here. There are daily posts on this topic on the Baby Center forum Surviving Reflux: Dealing with Colic, Reflux, MSPI  and I suggest you check it out.

The reason for the lack of info? Simply, I have no experience. The medication route was never advised by multiple docs, nor pushed by myself. I had a fat and “happy” spitter, which meant a “laundry problem” for me. Oh, and 18 months of no sleep and constant anxiety. 

If hindsight is 20/20, then my foresight was 50/50. I felt I had two clear choices:

1. Demand medication and find a doctor that would agree, or..
2. Go with my doctor’s recommendation, which was also my gut at the time.
   
   

The way I see it, at just a week or two old, I took my fork in the road too strong, and too early, without giving myself the options for detours along the way. All while under the obvious clear-headedness that comes after just giving birth and tackling home life with a newborn and two year old. 

He smiled, he laughed, he cried, he met milestones. He did what typical babies do, he just spit up each meal and couldn’t get rest (via nap or overnight). Still, I stuck to my guns, and my gut, that both he, and I, could make it through with this choice. 

As advised, my son needed to simply mature, eventually become more vertical each day, and he did outgrow it. Yes, he did spit up solids during this time, but the more solid the meal, the less the reflux persisted. Other than horrible sleep habits that were never quite worked out, I feel today that we did take the right path. But I can’t help but wonder if trying a solution would’ve made those 18 months better, more peaceful and more restful. Heck, I tried everything else.

There’s a reason that Medicate or Wait is part of my top 10 considerations for reflux families. Every parent comes into this situation with a position, that becomes influenced by experience and guided by medical professionals. 

Of parents I’ve talked to, no one situation has been alike. Some were prescribed medication right off the bat and solved many issues, and others tried many kinds with no luck at all. Some refused the recommended medicine, and others yet, like myself, found alternative tricks and tools to cope. 

My advice is to seriously re-examine your gut instincts with each passing phase. It’s to remind you that you are the voice for your child, even when that voice is a scared and shaky one (at whatever direction you take, or when you decide to change directions). 

Take a solid stance and press the issue until you can both find a new comfort level. And don’t be so stubborn, or sleep-deprived, to reconsider your options when your situation changes. 

If medication is on your mind, your first step is your doc, or a different doc, or yet a different doc. As far as online resources, there are tons of polarizing articles out there on both sides of the coin, and I never recommend trusting strangers on the Internet. If nothing else, you will see how not alone you are.

Have you found your swaddle swagger, or have things unraveled quickly in your house? 

In my mind, swaddling just makes sense. Doing what you can to transition your baby from the comfort of the womb to the real world. It might not work for everyone but there's some science behind the practice. 

Swaddling was critical to help my first born through his full six weeks of colicky behavior. Second child was swaddled from the get-go, but we had to be flexible for his safety and comfort due to his reflux (ex. avoiding when being propped up, etc.). We used light-weight swaddle blankets and the ready-to-wear velcro variety.

I WISH I had found the following resource from "The Survivor's Guide to Colic" online, before I had worked my way through all the other "S" techniques with my first born, you know sucking, ssshing, swinging, etc.:
Snuggled up Tight - Swaddling Methods to Settle Crying Babies . This article shares the purpose, the risks and the techniques to get your swaddle on. There's also a nice diagram via Peggy's Buzzfeed  article on baby hacks. 

However, when it comes to reflux babies, swaddling might work or it might not, it's all about trying to find the right comfort methods. One consideration is that crying can aggravate reflux further, so if the right swaddling technique helps reduce crying, it may also lessen the reflux. 

As with everything on this site - it comes down to your Doc's Advising, Your Gut Instincts and your Trials & Successes. 

Swaddling may help keep things together, but try not to get discouraged: there's not a blanket approach to caring for a fussy newborn. 

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You got the cake, you lit the candles and sang the song. But something about this birthday isn't all that happy. 

They said your baby would outgrow its reflux in 12 months and here you are. You made it through this first insane year, leaning on the premise "this too shall pass,"  but not sure what happens now.

Or maybe you've had a pretty good go at year one, but suddenly things have changed for your child - and drastically - with no obvious cause.

According to Crying Over Spilt Milk, when reflux (in all forms) persists or emerges past age one, it can be be difficult to gain support from health professionals, who might attribute challenges to more "behavioral" concerns than lingering reflux issues or complications. 

In addition to the obvious signals such as continued spit up and vomit (long after they've gone vertical), some common symptoms, as shared in the article, include, but aren't limited to:

• Irritable, clingy, cries lots
  
• Sleeps poorly, wakes often
  
• Poor eater, or refuses to drink/eat
  
• Becomes worse if given acidic, spicy or fizzy food
  
• A virus, ‘stomach bug’ or teething may trigger an attack of reflux
  
• and more (Read the full helpful article here)

It was hard enough figuring out how to help and comfort your newborn or infant, but reflux in older babies brings a whole new set of challenges as they grow. And until they can learn to express themselves through a form of communication, the cries can only get louder, longer and deeper into your psyche. 

For more on this challenging topic, check out this comprehensive article from RISA, the Reflux Infants Support Association, on Reflux in Older Children, beyond the 12- to 18-month-window that most parents expect to be through with reflux. 

As always, hang in there, stay tough, and find a way to celebrate the good days; cake or no cake. 

Trial. That is the best word that sums up a parent's experience when a newborn or infant shows signs of reflux, GERD, silent reflux and similar issues. 

From the trials and errors in remedying the situation, to serving as the judge, jury and defendant in your own case of the century. 

For the breastfeeding and pump-tastic moms, one of the first "tries" involves eliminating possible trigger foods from the diet.

According to La Leche League International these include, but aren't limited to the following:

"Since several studies have shown a strong link between GERD and cow’s milk allergy (Iacono et al 1996), diet management can be effective in this disease. Other common offenders are soy, eggs, and wheat. A two-week elimination of all dairy products from mother’s diet often produces noticeable improvement in a baby suffering from cow’s milk allergy. Too much caffeine consumed by the baby’s mother (which relaxes the LES) can cause a problem for some babies, as can exposure to cigarette smoke (Alaswad et al 1996)."

Other possible triggers mentioned online include peanuts, tree nuts, chocolate, and other common allergen culprits. Or as described in the KellyMom article Spitting Up & Reflux in the Breastfed Baby, "...is baby getting anything other than breastmilk – formula, solids (including cereal), vitamins (fluoride, iron, etc.), medications, herbal preparations? Is mom taking any medications, herbs, vitamins, iron, etc.?"

When improvement isn't seen, some moms turn to the unofficial Elimination Diet, outlined here by Ask Dr. Sears.

What did your doctor recommend as your best defense in this case? 

Or did changing your diet do nothing more but eliminate it as the source of the problem? 

If you're reading this you might already have your doc's number entered in your phone, just hesitating to push call. 

• Is this normal? 
  
• Am I overreacting? 
  
• Is my sleep deprivation turning a molehill into a mountain of dirty bibs and burpers?
  

If you're not quite ready to call your doctor you can safely watch this doctor's video first, "How much spit up from my baby is normal before I call the doctor?" by Dr. Ann Kellams. I don't know her obviously but her resume seems legit, and her advice is pretty standard. 

Or you can check out this incredibly helpful Parent Checklist for Reflux from GIKids.org (PDF download). I'd bookmark this or print it. They have a ton of other helpful info on their site too. 

My advice is to always call - no matter what you're feeling - even if the talk or visit just gives you the reassurance to keep tackling each day.