Reflux? Colic? Unsettled baby
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.