You notice your baby is spitting up frequently after feeds, is unsettled, and is increasingly more distressed. As a parent, your default reaction is to think, “What’s wrong? How can I help?” or feel confused as to what could be happening. Reflux in babies is more common than you think, and in some cases, babies need adjustments or treatments to reduce discomfort.
We’ll talk you through what baby reflux is, how to recognise signs of reflux in babies, and how to help your baby with reflux.
What Is Reflux in Babies?
Gastro-oesophageal reflux (GOR) occurs when milk or food travels back up the oesophagus from the baby's stomach, sometimes causing them to spit up or feel uncomfortable. Feel reassured that it’s very common to see signs of reflux in newborn babies, and it often doesn’t require any treatment.
When your baby feeds, the muscle in the lower oesophagus opens to let food and milk into the stomach. If this muscle is weak, food and milk can travel back through this opening, leading to baby reflux. As your baby develops, this muscle gets stronger, and reflux no longer occurs.
When reflux symptoms in babies become a clinical concern, medical professionals will refer to this as Gastro-oesophageal Reflux Disease (GORD). Treatment options such as changes to your feeding routine, diet alterations, x-rays, and medication are used to help reflux in babies.
When Does Reflux Start in Babies?
Reflux in babies typically starts from before 8 weeks old up until your baby is a year old. Baby reflux can peak at around 4 months as they start to drink more milk to aid their development. Babies are also more active and have a purely liquid diet, making it easy for milk to travel back through the lower oesophageal sphincter (the valve where milk and food pass through to the stomach).
From 12 months, symptoms of reflux in babies can improve dramatically because they’re able to sit upright and have already started to be weaned onto solid food. Symptoms of reflux in babies can appear differently in newborns compared to older babies.
Reflux in Babies: Symptoms to Look Out For
Some baby reflux symptoms are more visible than others, especially if your baby has silent reflux. Some common symptoms of reflux in babies are:
- Frequent spitting up or vomiting after feeds
- Bringing up milk between feeds
- Swallowing or gulping after feeds
- Irritability or crying during or after feeding
- Arching the back during or after feeds
- Poor weight gain (in some cases)
- Feeding refusal
Less obvious symptoms of newborn reflux:
- Hiccups
- Persistent cough or wheeze
- Disturbed sleep
- Appearing uncomfortable when lying flat
What Causes Reflux in Babies?
The biggest cause of reflux in babies is that their digestive system is immature and yet rapidly developing. Premature babies can be susceptible to reflux because their bodies are less developed. Newborn babies spend a lot of time being cradled or lying down, and this can contribute to reflux.
When you are positioning yourself and the baby to feed, ensure they are sitting up slightly and have chances to pause between latches. This can also help you recognise when your baby is ready to stop so they are not overfed, which also contributes to reflux in babies.
Although treated as separate conditions, if your baby has a sensitivity to cow’s milk, it can lead to reflux. The two conditions can overlap, so it’s not uncommon for a medical professional to check this if you have concerns about baby reflux.
How to Help a Baby with Reflux
It’s common for babies to bring up a little milk after a feed, so you don’t need to be concerned as long as they are happy, healthy, and showing signs they are gaining weight. If you have concerns and need to make adjustments to lessen your baby’s reflux symptoms, this is the advice given to parents before other treatment options are explored.
Feeding adjustments
- Get advice from your health visitor about how to bottle feed your baby or check your baby’s latch when breastfeeding
- Smaller, more frequent feeds
- Keep your baby upright during and after feeds for at least 30 minutes
- Burp or wind your baby during and after feeding, trying different positions to see how your baby is most comfortable
Positioning
- Avoid lying your baby flat immediately after feeding
- Elevating the head end of the cot or Moses basket is no longer recommended by medical professionals
- Get advice about your baby’s breastfeeding or bottle-feeding position
- Your baby must sleep flat on their back, not on their side or their front
For breastfed babies
- Check if your baby is latching correctly, so they’re not inhaling lots of air when feeding
- Consider dairy in the mother’s diet if other symptoms suggest CMPA
For formula-fed babies
- Anti-reflux (AR) formula may be recommended by a GP or health visitor (this is a thickened formula milk)
- Do not switch formulas without guidance or advice from your healthcare professional
- Try using a baby bottle with an anti-colic valve
When to speak to a GP
- Poor weight gain
- Blood in vomit or stool
- Projectile vomiting
- Symptoms worsening after 6 months or persisting beyond 12–18 months
- Gets reflux for the first time after the baby is 6 months old
- Significant distress in the baby
- Has a swollen or tender stomach
- High temperature or feverish symptoms
- Cannot keep any fluid down and keeps being sick
- The baby is refusing to feed
Baby Reflux: Treatments to Help Your Baby
The first line of treatment offered is adapting your feeding routine and feeding positions. These adjustments alone can make a huge difference to reflux in babies. If your baby is still distressed and experiencing reflux symptoms, your doctor may suggest alternative treatments, such as:
- If your baby is formula-fed, thicken your baby’s milk with another powder (available from a pharmacy) or feed with pre-thickened milk.
- If your baby is breastfed, or the thickening powder does not help, other medicines can be offered to reduce the amount of acid produced in the stomach (e.g., Gaviscon Infant).
- If GORD is diagnosed, and the above treatments have not helped, alginate therapy may be recommended. When swallowed, the alginate creates a barrier at the top of the stomach to prevent milk and acid from re-entering the baby’s oesophagus.
Reflux vs. Silent Reflux vs. GORD: What’s the Difference?
To help you feel confident with the terminology and differences in types of reflux in babies, this is what sets apart reflux, silent reflux, and GORD.
Reflux: Typical baby reflux symptoms present, affecting the lower oesophagus. Medical professionals may refer to this as GOR (Gastro-oesophageal Reflux).
Silent Reflux: Symptoms of reflux are less visible as your baby may not visibly spit up milk. It can irritate your baby’s throat without causing heartburn, so the symptoms present differently from standard baby reflux.
GORD: A diagnosed chronic digestive disease where your baby has a weakened lower oesophageal sphincter (LES) and stomach acid repeatedly flows back into the baby’s throat or mouth.
How Lola&Lykke Supports Parents and Babies with Reflux
Supporting comfortable feeding from the start is at the heart of what we do. We pride ourselves on developing innovative products that help families with a smooth feeding journey. We publish a wealth of knowledge from real parents and maternal experts, covering relevant topics such as breastfeeding, postpartum, life with a newborn, and everything else pregnancy and parenthood throw at you!
Explore Lola&Lykke’s Complete Feeding System, and to learn more about the best baby bottles to use for baby reflux, learn more in our blog.
Baby Reflux FAQ’s
What is reflux in babies?
Reflux is a term used when babies spit up milk during or after feeding. It is very common in young infants as their digestive system is still developing. Most babies will experience reflux and not be distressed by it, and will stop presenting with reflux symptoms as they grow older.
What are the symptoms of reflux in babies?
The most common symptom is when a baby brings up their milk or is sick shortly after feeding. Other symptoms can be:
- Coughing or hiccupping
- Distressed when feeding
- Swallowing or gulping after being burped or fed
- Not gaining weight in line with their development, as they cannot keep their food down
What causes reflux in babies?
Reflux in babies is caused by a weak muscle in the lower oesophagus, which opens and closes to let milk and food pass through to the stomach. Sometimes, this valve doesn’t fully close, resulting in milk and food rising back into their throat or mouth. It can also be caused by:
- Lying the baby down straight after a feed
- Overfeeding
- Not sitting upright during feeding, check positioning
- Poor latch in breastfed babies
When does reflux start in babies?
Reflux in babies can start before your baby is 8 weeks old, and last up until they are 12 months. Due to development milestones, reflux can peak at around 4 months. If your baby starts presenting with reflux for the first time after they are 6 months old, seek advice from your doctor.
How do I help my baby with reflux?
Firstly, check your feeding position and, if relevant, your bottle feeding technique. Try smaller and more frequent feeds to start with, checking that your baby is feeding correctly. When they have finished feeding, burp your baby to release any trapped air caused by feeding.
What is the difference between reflux and silent reflux?
Silent reflux differs from normal baby reflux because babies can experience reflux symptoms but not bring up any milk or be sick. Signs of silent reflux are hoarse coughing, constantly clearing their throat, refusing feeds, or arching their back when trying to be fed.
When should I take my baby to the doctor for reflux?
If you have made adjustments to your feeding routine and positioning, and your baby is still unsettled during feeds or showing any signs that they are not gaining weight, you will need to seek advice from your doctor. More urgent symptoms to be aware of that would trigger an appointment are:
- Blood in vomit or stool
- Projectile vomiting
- Symptoms worsening after 6 months or persisting beyond 12–18 months
- Gets reflux for the first time after the baby is 6 months old
- Significant distress in the baby
- Has a swollen or tender stomach
- High temperature or feverish symptoms
- Cannot keep any fluid down and keeps being sick
- The baby is refusing to feed
Does reflux in babies go away on its own?
Yes, most babies will experience reflux and not become distressed by it. They will continue to be happy and healthy, and outgrow any symptoms they once presented with. For babies where symptoms do not improve over time, seek advice from your healthcare professional for the best course of treatment.
