Reflux in babies

Put simply, reflux is when babies bring their milk back up during, or after, a feed¹. It’s also known as posseting², but it’s different to vomiting. There’s no straining involved and your baby is unlikely to be phased.

It's all down to physiology. The muscle surrounding your baby’s oesophagus (food pipe) isn’t fully developed at birth. This means that the milk and food your baby eats is able to travel right back up again. That’s why it’s not uncommon to see reflux in babies.

In most cases, you’ll see baby reflux symptoms before your baby reaches 2-3 months of age, and they’ll usually have stopped by the time they reach 12 months³.

Baby reflux symptoms might include^4,5

• Bringing up milk during or just after feeding.
• Coughing or hiccupping during feeds.
• Being unsettled during feeding.
• Swallowing or gulping after burping or feeding.
• Crying for long periods.
• Refusing to feed and/or gagging or choking while being fed.
• Poor weight gain.
• Frequent ear infections.

If your baby starts to show any of the symptoms of baby reflux, it’s best to be on the safe side and speak to your GP^6.

If your baby is showing the symptoms of reflux, without spitting out milk, then they could have silent reflux; instead of the milk flowing back up to the oesophagus (food pipe) and being spat out, it’s swallowed by your baby⁷.

Silent reflux can be confusing, hard to identify and incredibly frustrating. This is because whilst you might not be able to physically see what’s being brought back up, the baby reflux symptoms are very much at play. 

The symptoms of silent reflux are similar to those seen in regular reflux. The main difference between the two is that with silent reflux, your baby won’t bring up their milk after a feed. 

If your baby has been diagnosed with reflux, there are a few practical things you can do to make them more comfortable. Here’s a few remedies and practical tips on how to soothe baby reflux⁸:

• Avoid overfeeding – try giving your baby smaller amounts more often. This will help to avoid their tummy becoming too full.
• Burp your baby before, during and after feeding
• Keep your baby upright during, and for about 30 minutes after feeding - let gravity do it’s thing!
• Dress your baby in loose clothes and avoid anything tight across their tummy.
• Make sure that your baby sleeps flat on their back, rather than on their side or front.

If your baby is bottle fed, check that the hole in the teat is not too large. This can cause babies to gulp their feed too quickly. If your baby is having formula, you can also seek advice from your healthcare professional, who may discuss suitable specialist formulas for the dietary management of reflux. 

If you find that your baby is more unsettled at night time, you might want to try keeping your baby upright for as long as possible after their bedtime feed.

Whilst there’s no evidence to suggest that baby massage eases the symptoms of baby reflux, it can be a really good way of keeping you and your baby calm⁹. This is very important if you’re managing baby reflux on a daily basis. If baby massage is something that you’d like to explore, then it's always a good idea to discuss the technique with your GP.

In most cases, by implementing some of the practical steps above, reflux and silent reflux will settle down over time, and no treatment will be necessary. However, if your baby isn’t gaining weight normally, your doctor might feel that your baby needs some help to manage the problem, and offer medication.

This might be the case if your baby is diagnosed with acid reflux (GORD).

Acid reflux is also known as Gastro-oesophageal reflux disease (GORD). It’s important to know that this isn’t the same as regular reflux. It’s a more serious condition and if you think that your baby might be experiencing acid reflux, it’s always advisable to speak to your GP, as your baby may need medication to help them manage the symptoms¹⁰.

When a baby has acid reflux, the milk (or food if your baby is weaning), mixes with their stomach acid and travels back up the food pipe (oesophagus). This causes irritation and inflammation, which is painful for your baby^11.

There’s no doubt about it, acid reflux in babies can be stressful to deal with and in some cases, it can really affect the quality of day-to-day life with your baby.

That’s why it’s important to know the signs to look out for, so that you can be better prepared to help your baby and identify your next steps.

Here are some common baby acid reflux symptoms¹²:

• Being unsettled after feeding.
• Difficulty feeding your baby (such as refusing feeds or crying during feeds).
• Your baby is spitting up frequently.
• Your baby is showing signs of abdominal pain.
• Low weight gain or even loss of weight.
• Frequent chest infections.

In the majority of cases, babies grow out of reflux by the time they are 12 months old¹³. There’s no concrete answer here, but as your baby grows older, the muscle around their oesophagus will become stronger, making digestion easier for your baby.
If your baby is still experiencing symptoms of reflux after the age of 12 months, be sure to seek advice from your GP ¹⁴ to discuss how to move forward.

Reflux can affect your baby whether they’re breast or bottle fed. Remember that if you are breastfeeding, you should continue to feed your baby as usual. 

It’s tempting to explore the foods to avoid when breastfeeding a baby with reflux, particularly if you suspect that your baby may have an allergy or intolerance to cow’s milk. However, it’s important not to cut anything out of your diet without first consulting your GP for advice.

When it comes to weaning a baby with reflux, you might think that starting earlier will ease some of the symptoms. However, it’s important to remember that reflux isn’t confined to those babies who have a milk only diet, and the NHS recommends that you wait until your baby is around six months old befoe weaning starts.

In the first instance, weaning is all about introducing your baby to solid foods, and getting them used to trying a variety of different tastes and textures, rather than ensuring that they consume large quantities of food.

While your baby is getting used to eating solids, keep going with your usual breastfeeding or formula feeding routine. Start off with puréed or blended foods and then move on to mashed or finger foods. Your baby may spit the food out when you introduce solid foods, but this is because they’re figuring out how to chew and swallow. The most important thing is to just be patient and keep trying as your baby gets the hang of things.

While reflux is normal and should pass with time, it’s always a good idea to talk to your health visitor, pharmacist or GP if you’re concerned about your baby’s symptoms. Always speak to a healthcare professional if your baby is vomiting regularly, bringing up large amounts of milk or has discomfort while feeding, so other causes can be ruled out.

If your baby is diagnosed with reflux, your healthcare professional will be able to advise on practical ways you can ease the symptoms and, if appropriate, talk you through the nutritional solutions available.

Our Baby Symptom Checker is a useful way to check your baby’s symptoms if they’re less than a year old. It offers some practical advice and guidance too.

The main thing to remember about reflux is that although it can be distressing for parents, it’s very common and completely normal. You may worry that your baby isn’t getting enough nutrients, but this is very rarely the case. As long as your baby’s not showing signs of discomfort or losing weight, there’s usually no cause for concern¹⁵.

Talking to friends and other new mums can help to reassure you, and our Careline team is also available to answer your questions or listen to any worries you might - big or small, anytime, day or night.