Baby Reflux – How to Help Your Baby Feel Better

It’s not unusual for babies to spit up a little breast milk or formula from time to time during or after a feed. But if spitting up – also known as reflux – happens a lot and is causing your little one discomfort, it could be a sign of a condition called gastro-oesophageal reflux disease, or GORD for short.

Although you may have thought only adults have acid reflux, babies can have it, too. In this article, we’ll explain why this happens.

Read on to find out how to recognise the signs and symptoms of reflux and GORD in babies and what you can do about it, as well as when it’s important to see your baby’s doctor.

What Is Acid Reflux and Gastro-oesophageal Reflux Disease (GORD) in Babies?

Reflux – also known as posseting, or just ‘spitting up’ – happens when some of the contents of your baby’s stomach travels back up the tube (known as the oesophagus or ‘food pipe’) that transports foods and liquids from the throat to the stomach.

Reflux is very common in newborn babies because the muscle that closes off the food pipe from the stomach is still not fully developed. If it opens when it shouldn’t, breast milk, formula or food can travel back up towards your baby’s throat.

Spitting up is not the same as vomiting. If your baby is being sick, you’ll be able to see the muscles tensing up in his or her throat. With reflux, the breast milk, formula or food is just burped up or dribbles out with no effort at all.

Although reflux is very common in babies and usually nothing to worry about, sometimes a little stomach acid may be mixed in with the milk or formula that comes up, and this can cause uncomfortable heartburn for your baby.

When reflux is painful and chronic, that is, it starts happening all the time, it’s referred to as gastro-oesophageal reflux disease, or GORD.

GORD can be uncomfortable for your baby and challenging for you as a parent, but the good news is that your little one will usually grow out of it by the age of 12 months. Reflux is most common in babies who are younger than 3 months old.

What Causes Reflux in Babies?

As mentioned above, the cause of reflux in babies is generally because their food pipe is not fully developed yet. This can lead to the muscle at the bottom of the food pipe opening when it shouldn’t and allowing any food in the stomach to come back up the pipe towards the throat. However, it’s generally something babies grow out of as they develop.

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Signs of Reflux in Babies

If you’re seeing any of the following symptoms in your baby before or after a feed or meal, they may have reflux (or GORD if the symptoms are happening very frequently):

• Often bringing up milk during or after feeds

• Frequent bouts of coughing or hiccoughs

• Swallowing or gulping after burping or after a feed.

Gord Symptoms

Gord is a more serious version of acid reflux. If your baby experiences acid reflux symptoms very frequently, the food pipe can become sore and inflamed from the stomach acid. In this case, it’s important to see your baby’s doctor, who may prescribe medicine to treat the problem. Signs that your little one may have GORD include:

• Refusing feeds, gagging or choking mid-feed

• Crying or generally being unsettled when feeding

• Frequent ear infections.

What Is Silent Reflux in Babies?

Your baby can have reflux without any obvious signs like spitting up, which may make it harder to spot. This is known as silent reflux, and it can happen when babies swallow the regurgitated food again instead of spitting it out.

Signs and Symptoms of Silent Reflux in Babies

With silent reflux, babies don't spit up their food, so you need to look for other symptoms. The symptoms of reflux and GORD mentioned earlier may also be present in silent reflux, such as crying or being unsettled after feeds, or coughing.

If you suspect your baby might have silent reflux but you aren’t sure, talk to your midwife, health visitor or doctor.

How to Treat Silent Reflux in Babies

Silent reflux is generally treated in the same way as reflux or GORD, depending on the severity. Read our section below on ‘How to Treat or Prevent Reflux in Babies’ for some guidance on treating silent reflux. Some examples include holding your baby upright during feeding and for as long as possible afterwards or regularly burping them during feeds.

Your doctor may also recommend using a thickening powder for formula milk or certain medicines to reduce stomach acid. It’s always best to seek your doctor’s advice if you suspect your little one has silent reflux.

How to Treat or Prevent Reflux in Babies

Most children grow out of reflux or GORD by the time they’re 12 months old, without needing any medical treatment. In the meantime, if you’re wondering how to help reflux in babies, here are some things you can try to help prevent or reduce reflux in babies, or some treatments your doctor may recommend. The following may also help prevent occasional reflux from turning into GORD:

• Feed your baby smaller amounts more frequently

• Burp your baby more frequently, both during and after each meal

• After a feed, keep your baby in an upright or semi-upright position (an angle of around 30 degrees is ideal) for at least an hour. Keep in mind that putting your little one in a baby chair or bouncer that’s inclined at too steep an angle may cause them to slump, which can make the reflux worse.

• Put your baby to sleep on their back instead of their front or side

• If you’re formula feeding your baby and your doctor or health visitor advises it, switch to a thicker formula that doesn’t come up so easily

• If your doctor thinks the reflux may be caused by an allergy to the cow’s milk in formula, they may advise you to switch to a formula that doesn’t contain this ingredient

• Always ask your doctor before trying any special ‘anti-reflux’ milk, especially if your baby is already receiving anti-reflux medicine.

When Does Reflux Peak in Babies?

Reflux usually starts in babies before they reach 8 weeks of age. During this early stage of infancy, it usually reaches its peak as your baby’s digestive system is still developing. While most babies experience some form of reflux during these initial weeks, it’s typically not a cause for concern.

When Does Reflux Stop in Babies?

So, when does reflux get better in babies? As babies grow, their digestive system matures, which may help reduce the frequency and severity of reflux episodes. The peak period of reflux generally subsides as they approach the age of 4 to 6 months.

By the time babies reach their first birthday, reflux is typically much less of a problem.

When to Call Your Doctor

Reflux isn’t usually a problem as long your baby seems generally happy and well, and his or her weight gain and growth are on track.

In some cases, the reflux may be caused by an underlying condition that needs to be diagnosed and treated. See your doctor if you notice any of these symptoms:

• Reflux that starts when your baby is 6 months old or later

• Reflux that doesn’t clear up by the age of 12 months

• Fever (a high temperature of over 38 degrees Celsius)

• A lot more crying or distress than usual

• Weight loss or no weight gain

• Reflux that often ends in projectile vomiting

• Yellow or green vomit

• Blood in your baby’s poo

• A swollen, hard or tender stomach

• If your baby arches their back during or after a feed.

Testing for Reflux and GORD

Your child won’t usually need medical attention for reflux or GORD, but if your baby is struggling to gain weight properly or is in extreme discomfort because of reflux, your doctor may prescribe medicine or decide to run tests to rule out other problems.

Some of the tests used to diagnose severe reflux or GORD may include:

• Barium swallow. This is when your baby is given a drink containing barium, which shows up on an x-ray. This helps doctors to see if there are any problems such as a narrowing of the food pipe.

• Gastroscopy. A tiny fibre optic camera (called an endoscope) is used to see inside your baby’s oesophagus and/or stomach. This allows the doctor to look for any abnormalities that might be causing the reflux. It’s done in hospital under a general anaesthetic, so your little one won’t even be aware of what’s happening.

• Gastric emptying scan. This is a test to find out how quickly your child’s stomach empties. Its purpose is to rule out the possibility that the reflux is due to the food staying in your baby’s stomach for too long.

• pH probe. A very small, soft flexible plastic tube is gently inserted into the food pipe to record acid levels. This test is done in hospital and requires an overnight stay.

The Bottom Line

Most bouts of reflux will clear on their own in time, but if this condition does develop into GORD, it can usually be treated and managed successfully by your doctor. If you think your baby’s reflux is getting worse, ask your doctor or health visitor for guidance. It’s a good idea to be proactive so that you can help prevent the reflux from getting worse and turning into GORD.

_{How We Wrote This Article The information in this article is based on the expert advice found in trusted medical and government sources, such as the National Health Service (NHS). You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.}