If your baby is bringing up milk after feeds, it could be a sign of reflux, or in rarer cases, a more serious condition called gastro-oesophageal reflux disease (GORD). Reflux is common during a baby’s first year and usually resolves itself.

Gastroesophageal reflux disease (GERD) occurs when the reflux is persistent. It’s crucial that parents can tell the difference, as GERD may require medical treatment. Find out why infant reflux occurs, common symptoms, and what you can do about it as parents.

What Is Reflux in Babies? 

Baby reflux is when the contents of the stomach are regurgitated up into the oesophagus (food pipe), throat, and mouth. Usually, this is milk (the baby’s primary diet).

While it might be distressing, it’s extremely common and harmless. In fact, it can occur up to six or more times per day. Parents often refer to it as “spitting up” or “posseting” — it’s all the same thing.

Almost half (4 in 10) of babies under a year old will experience reflux. In most cases, the condition resolves after a year and requires no testing or medical treatment.

Comparing Gastroesophageal Reflux (GER) and GERD 

If GER (baby reflux) is mostly harmless, when do parents need to be concerned? Well, as in adults, some mild reflux doesn’t cause any problems. The issue occurs if the reflux becomes persistent and uncomfortable.  

Let’s compare the differences between GER and GERD: 

• Gastroesophageal reflux (GER): This is occasional acid reflux, often called heartburn or indigestion in older children and adults. It’s harmless and common in babies, usually resolving by their first birthday. Small feeding changes can help reduce spit-up.

• Gastroesophageal reflux disease (GERD): GERD is more frequent and severe, potentially affecting a baby’s feeding, growth, or comfort. It may cause oesophageal irritation and often requires medical treatment. 

GERD is, therefore, much more of a concern. Look for distressed behaviour, unexplained crying, projectile vomiting, refusal to feed, failure to gain weight, and choking, gagging, or wheezing. These are all indicators of GERD. 

Symptoms of Baby Reflux 

Telling baby reflux from GERD can be difficult. Often, the primary difference is the severity of the symptoms. GERD is more uncomfortable and persistent.  

Common symptoms of baby reflux include: 

• Frequent spitting up or vomiting

• Coughing or hiccupping during or after feeds

• Arching the back or fussiness after feeding

• Refusing feeds or feeding in short bursts

• Poor weight gain

• Crying more when lying flat

• Swallowing or gulping after burping

What Causes Reflux in Babies? 

Baby reflux occurs because the gastrointestinal tract is much shorter in infants. Compared to adults and even children, the distance from the stomach to the mouth might be just a few centimetres. So, it doesn’t take much to cause a reflux episode. 

The lower oesophageal sphincter, which separates the stomach from the oesophagus, is also underdeveloped. It might not stay shut all the time, letting food backflow. 

When Does Baby Reflux Occur? 

Reflux in babies begins before the baby is 8 weeks old. As they grow, the oesophagus becomes longer, resulting in a gradual decrease in reflux episodes. The condition peaks around 4-6 months before declining as they reach 1 year old. Around 90% of babies with reflux stop having symptoms before their first birthday. 

The condition is more common in premature babies, as the connection between the stomach and oesophagus is lower. Other risk factors include: 

• A hiatal hernia

• A neurological or brain-related condition

• Cystic fibrosis

• Epilepsy

• Born with an abnormality in the oesophagus

• Asthma

How to Prevent Reflux in Babies

It’s alarming to see your baby bringing up lots of milk. Even worse, if they’re distressed, refusing to feed, or crying throughout the night. While it’s important to keep an eye on the condition, it should get better. 

That being said, there are a few things that can improve symptoms. 

1. If breastfeeding, you should continue to do so. Your doctor may prescribe a medicine called alginate, which can help.

2. If using milk formula, your doctor might recommend switching to a thickened feed. The extra thickness reduces the risk of reflux. A course of alginate may also be helpful. 

You should be concerned if the reflux continues past 1 year old, or if there are other symptoms, e.g., blood in faeces, persistent diarrhoea, and eczema. These symptoms can indicate a cow’s milk allergy (another cause of baby reflux). 

Don’t Ignore Reflux Symptoms 

Need specialist support? If you’re beginning to get worried about your baby’s reflux, it’s time to seek help. The Functional Gut Clinic offers a range of expert testing and guidance for adults and children with persistent reflux or suspected GERD. 

Get peace of mind and explore our testing options today.