Skip to content 
Important Points
- Reflux, which affects about 40% of babies, occurs when stomach acid backs up into the esophagus, usually after a meal.
- Common symptoms include mild milk loss, back pain, and cramping; Awareness includes observing feeding, crying, and vomiting
- Gastro-oesophageal reflux disease (GORD) has serious symptoms such as refusal to eat, cravings, and changes in weight.
- Treatment focuses on relieving symptoms, including eating well, sleeping well, and, if necessary, medications to reduce stomach acid production.
Acid reflux or just ‘reflux’ is a common problem in babies. About 40% of healthy, developing children will have reflux to some degree. Reflux usually starts before eight weeks and peaks after four months before gradually improving. Reflux is often related to the growth of the baby’s intestines and after a while it will grow well without special treatment.
Reflux happens several times a day, even more often after breastfeeding and when there is milk in the baby’s stomach.
Although reflux is common and most babies do not need special treatment, some babies are more affected by the condition and do not grow and gain weight as they should. When reflux is severe, it is called GORD – gastroesophageal reflux disease.
What is reflux?
Reflux occurs when the muscle tissue between the end of the baby’s esophagus (food pipe) and the top of his stomach relaxes. This causes the stomach to move from the stomach into the food pipe and out of the baby’s mouth as vomit, posset or throw up.
Premature babies may be at greater risk of developing reflux than full-term infants. Exposure to secondhand smoke can also affect some babies. Do not smoke near your child and do not allow others to do so.
Does reflux cause pain?
Milk is digested by acid in the baby’s stomach. Their stomachs are designed to handle the feeling of acid even though their esophagus is not. This is why babies are often uncomfortable and sit unsteady when they reflux.
How do I know if my child has reflux?
Your baby may have reflux but don’t worry about it. Babies with reflux tend to bring milk to their mouths without difficulty instead of vomiting and that is why they are called ‘happy chuckers’.
Many parents have heard the term ‘silent reflux’, although recent evidence does not support this. Babies who do not vomit or do not vomit are unlikely to have reflux and often, crying and irregular periods are due to tiredness or hunger.
You may need to keep a diary to record your baby’s feeding, crying and vomiting. This will make it easier to monitor any changes and provide an accurate record to your child’s health nurse and/or doctor.
Common symptoms of reflux include:
- A small loss of milk or a ‘load’ of milk after and between meals.
- Backsliding and instability. Children may act like they are trying to stretch or stretch themselves to solve a problem.
- Swallowing even when not eating.
Is reflux dangerous for my child?
Reflux is not dangerous unless the baby produces milk (aspirates) from their lungs. When a child has GORD, their growth may be affected because they are vomiting and may not be able to eat properly. Sometimes a baby’s nose burns because of stomach acid.
What is the difference between reflux and Gastro-oesophageal reflux disease?
Children with GORD can show a variety of symptoms, although the most common include:
- Arguing or refusing to feed. Feeding hurts them so they learn that feeding can be difficult.
- Breathing – the milk enters the trachea (windpipe) and not the esophagus (feeding tube).
- Coughing, shortness of breath or wheezing.
- Internal changes weight and weight loss.
- Blood in their vomit.
Babies with cow’s milk protein deficiency (CMPA) can show symptoms similar to babies with GORD. Although rarely, they also have changes in their poos that show blood and mucous.
What is reflux management?
Reflux treatment depends on the symptoms. There is no cure for reflux and treatment, if necessary, is usually based on reducing the child’s symptoms. Mild reflux usually requires no treatment other than keeping the baby upright after breastfeeding.
- If you are eating a bottle your child, try to feed them in the most upright position.
- Hold your baby’s head upright for 20-30 minutes after feeding.
- Always follow through safe sleeping tips and put your baby on his back to sleep. There is no evidence that sleep (abdominal) sleep or elevating the crib makes any difference.
- Sometimes solid foods, for example, the use of anti-inflammatory drugs in bottle-fed babies, can help reduce vomiting.
Reflux treatment
Medicines can be helpful to control the amount of acid produced in the baby’s stomach. In general, a four-week trial is recommended to see if it makes a difference. Reflux medicine they are written according to the child’s height and weight. Regular reviews, every four weeks are recommended for babies with reflux medication.
What not to do for reflux
You know your child better than anyone else. Experiment with different positions and see which relaxation techniques work best.
As a rule:
Avoid it the use of anti-reflux drugs and thickening agents in the formula – these can cause intestinal obstruction.
Avoid it thinking you should stop breastfeeding. Breastfed babies are the same as breastfed babies and there is no benefit to stopping breastfeeding in the hope that it will improve reflux symptoms.
Avoid it introducing solid foods early in the hope that they will help ‘wean down’ your baby’s milk supply. Now, there is there is no evidence to help start solids (about) six months and as the child grows.
When will my child grow out of their reflux?
Most children outgrow it by 18 months of age but show improvement when they are able to sit down. Position seems to help with reflux and the longer a child sits, the more their reflux symptoms change.
For more information on reflux
- Talk to your Child Health Nurse, GP or paediatrician.
- Go to the Reflux Infants Support Association – check it out Here.
Written by Jane Barry, Midwife and Child Health Nurse
References:
Clinical Practice Guidelines: Gastrooesophageal reflux disease in infants (rch.org.au)
Gastro-oesophageal reflux & GORD: infants | Raising Children Network
Infant reflux – Better Health Channel
Reflux Page | Child Health Queensland
Reflux Infants Support Association Inc – Reflux Infants Support Association Inc