Reflux is when the contents of the stomach are regurgitated (brought back up), either up the oesophagus (food tube) or into the mouth. The medical term for reflux is gastro-oesophageal reflux, or GOR. Most reflux is swallowed back into the stomach, but occasionally your baby will vomit it
out of their mouth (which is sometimes called posseting).
Although it can be very alarming for parents at first, reflux is very common in babies, and will most likely get better on its own by the time your child is one year old. In most cases, reflux will not harm your baby, and does not need any medical treatment. It is unlikely to cause problems
later on in life.
In some instances, reflux can lead to complications. This is called gastro-oesophageal reflux disease (GORD). Your baby will need to see a doctor if they have GORD.
Signs and symptoms of reflux
If your baby has reflux, they may start to vomit milk, especially after feeds. Most babies with reflux are otherwise well, and show no signs of discomfort or distress. They are growing well and their breathing is normal.
If your baby has GORD, they may:
- have pain and discomfort in their chest or upper abdomen (stomach), which will make them irritable, cry a lot or arch their back
- have disrupted sleep or be hard to settle
- show poor weight gain
- have breathing and swallowing problems (e.g. gagging, choking, wheezing or coughing a lot).
What causes reflux and GORD?
In babies, it’s common for the valve at the top of the stomach to be quite loose, allowing stomach contents to travel backwards up the oesophagus. As your baby grows older, this valve usually becomes stronger (and your baby spends less time lying flat on their back) and the reflux gets
better.
Care at home
For most babies, you don't have to do anything about reflux and regurgitation. It is a natural process that will resolve by itself with time. Some babies regurgitate more than others – this does not necessarily mean there is anything wrong.
It is possible to reduce the number of reflux episodes holding your baby in a more upright position when feeding. Try keeping them upright for about 20 minutes after their feed.
You can also try keeping your baby in an upright position or placing them on their tummy, instead of placing them on their back, in between feeds. Only do this if your baby is awake and if you or another adult is with them. However, having tummy time will not reduce the age at which the reflux
will get better.
Changing formulas or changing from breastfeeding to bottles will not have any effect on the reflux and is not recommended.
If your baby is otherwise well but has reflux and you are concerned, see your GP, paediatrician or Maternal and Child Health Nurse.
When to see a doctor
See your GP if your baby has any of the symptoms of GORD. The doctor will check your baby's growth and development, and if necessary they will refer you to a paediatrician. Further tests may be arranged if your doctor is concerned.
You should also see your GP if your baby:
- has blood or bile (a yellow fluid) in their vomit
- has a fever
- suddenly starts to regurgitate or vomit when they never have before
- won't feed
- is making you worried for any other reason.
Treatment of reflux and GORD
Most babies with reflux do not need any treatment at all.
If the reflux is causing problems or your baby has GORD, the doctor may suggest some treatment, such as feeding your baby thickened fluids. Pre-made thickened fluids are most suitable but these can cause constipation.
In some cases, medications can help. These might be a medicine to reduce the acid in the stomach, or medicine to treat an underlying infection.
Key points to remember
- Reflux is very common in babies, and will usually get better by itself by the time they are one year old.
- In most cases, reflux will not harm your baby, and doesn't require treatment.
- If the reflux is causing problems, this could be gastro-oesophageal reflux disease (GORD), which may need treatment.
- If your child has GORD symptoms, see your GP.
For more information
Common questions our doctors are asked
If my baby has reflux, could she be allergic to milk?
Some infants who have severe reflux, difficulty feeding, are
extremely irritable and have poor weight gain may have an allergy to a milk
protein. See your doctor for advice on breastfeeding and formulas that may help
in this situation. The most common proteins that babies are allergic to are
cow's milk and soy.
Does my child have silent reflux?
Some people believe that an unsettled baby who does not
vomit or posset may suffer from 'silent reflux'. However, this is not a medical
diagnosis. The term is very controversial as there is no scientific evidence to
support this.
Is it OK to make my own thickened fluids for my baby by
adding rice cereal to expressed breastmilk?
If your GP or Maternal and Child Health Nurse has
recommended that you thicken breastmilk for your baby in this way, it is OK to
do so if you follow their instructions. However, it is better to use specially
pre-thickened fluids.
Could reflux be the cause of my baby's colic?
It is common for young infants to have extended
crying and unsettled times, which are known as colic. There are many possible
reasons for colic, and reflux is one potential cause. Some babies are more
likely to be frightened by new physical sensations, including gas (wind) or
reflux. If your baby is crying for most of the day, or you are worried about
them, see your Maternal and Child Health Nurse, paediatrician or GP.
Developed by The Royal Children's Hospital Emergency, Gastroenterology and Clinical Nutrition departments. We acknowledge the input of RCH consumers and carers.
Reviewed May 2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au.