Posseting
Sodium Alginate & Magnesium Alginate
Posseting is the repeated, effortless regurgitation of small quantities of milk after each
feed. This doesn’t harm your baby and they should be otherwise well and thriving.
Posseting occurs when abdominal pressure overcomes an infant’s immature or weak
lower oesophageal sphincter (LOS) – the muscular valve between the oesophagus and
the stomach which usually prevents regurgitation. Milk easily bypasses this muscle
especially when the infant is lying down.
Almost all babies posset to some extent in the early months. Some bring back milk at every feed and sometimes more than once. In most babies, posseting is at its worst between 1 and 4 months. It generally resolves naturally by 18 months as the muscle strengthens, the infant eats more solid food and spends more time in the upright position.
How will I know if an infant is posseting?
Posseting causes no pain or discomfort and your baby will have no other symptoms except effortless regurgitation of milk after a feed. Your baby should be feeding normally and gaining weight.
What else might it be?
Gastro-oesophageal reflux disease (GORD) is the name reserved for a more serious complication involving repeated regurgitation that harms the infant. Symptoms include:
- poor weight gain (because a lot of milk is regurgitated)
- refusing feeds or pain on feeding
- blood streaked vomit
- a recurrent cough, wheezing or choking
- episodes of apnoea (stopping breathing).
If your baby has any of these symptoms you will need to take your child to see the doctor so that they can exclude other causes. If GORD is confirmed, the doctor may recommend the same strategies and treatments used for posseting (see below), or refer your baby to hospital for further investigation.
Projectile vomiting, where milk literally spurts out of the infant’s mouth and across the room, suggests a narrowing of the valve that controls the exit of food from the stomach. If your baby is projectile vomiting it is important you seek medical help.
What to expect:
Although posseting usually resolves naturally by 18 months and rarely requires investigation, it does require treatment. This is because 1 in 10 infants develop complications such as weight loss & dehydration. There is also a risk of the feed entering the lungs and causing breathing problems.
How to Treat:
Posseting can often be managed without the need to see a doctor, using simple behavioural techniques. Some suggestions include:
- Handling your baby extra gently, especially when winding
- Raise the head of the cot slightly (check with a health visitor)
- Give smaller feeds more frequently
- Keep your baby upright during feeding and for at least 45 minutes afterwards
- Ask your health visitor for advice about feeding techniques
- Avoid changing your baby’s nappy when their stomach is full.
On the advice of your doctor or pharmacist a medicine may be required to treat posseting. Gavsicon Infant is a reflux suppressant which is suitable for breast or bottle fed babies of any age, and is sugar free. However, it should not be used without medical supervision. For breast-fed infants, Gavsicon Infant is mixed with a little cooled boiled water and given by bottle or spoon after each feed. For bottle-fed infants, it is mixed with the formula milk.
