Reflux in babies: Signs, symptoms and management

Baby reflux, also known as possetting or spitting up, is when your little one brings up milk during or shortly after feeding. Although it is perfectly natural to worry something is wrong with your baby when this occurs, it is very common. Around 30% of all babies will experience baby reflux in their first year, so you won’t be the only one with a soggy shoulder!

It’s important to remember that newborn reflux is different from vomiting in babies, which is when a baby’s muscles forcefully contract to bring up food. If you’re not sure about your baby's symptoms it's always best to speak to your healthcare professional.

It doesn’t matter whether your baby is breastfed or formula fed, reflux in babies is very common, and you and your little one will most likely experience it at least once. It’s why baby muslins are a very useful bit of kit!

The reason your baby has reflux is because their oesophagus - the pipe that leads from their mouth to their tummy - hasn’t fully developed yet. This means the valve that normally closes over at the top of the stomach is not quite ready to do its job yet. During your baby’s first year, this valve gets stronger, which means their chances of getting reflux will decrease. But until then, this ring of muscle is still developing, which means that when your baby's tummy is full, milk and acid can occasionally come back up the food pipe, causing discomfort.

More often than not, you’ll notice the signs of baby reflux when it happens. Occasionally, however, your little one might swallow the milk, or it may not get as far down their mouth as it should, but they may not show obvious symptoms. This is known as silent reflux.

There are a few common reasons why babies get reflux:

• Your baby’s diet is almost exclusively liquid, which sloshes around a lot and can occasionally find its way back up and out of your little one’s mouth - especially since they spend a lot of time lying down.
• Your baby’s digestive system is still maturing, and they are still getting used to feeding.
• Too much food or milk taken at once can cause issues for your baby’s little tummy.

Your baby can have reflux at any age from roughly three weeks to one year old. Some common signs of reflux include:

• Bringing up small amounts of milk while feeding or for a short time afterwards
• Bringing milk back up two or more times a day for three or more weeks, without any other obvious signs of illness (like vomiting, retching, difficulty breathing or weight loss)
• Coughing, spluttering or having hiccups or wet burps
• Crying while feeding or shortly after feeding  
   

Other things to look out for:
 

• If your little one is a bit grouchy or appears to be in pain
• If your baby is waking up frequently, particularly after feeds
• Arching of the back after feeding, which could indicate your baby is bringing up milk

It is important to remember that reflux does not mean there is anything wrong with your baby. It is perfectly normal, but there are a few things you can do to help prevent acid reflux in your baby:
 

• Feed your baby in an upright position and hold them upright for a good 30 minutes after a feed. Let gravity take its course!
• Burping - this can be done before, during and after a feed.
• Feed them little and often. Remember, your baby’s tummy is very small when they are first born, so their stomach fills up quickly.
• If your baby is bottle-fed, check the teat you are using. If it is too big, your baby will guzzle the milk too quickly, and this can cause reflux. Having a smaller teat hole makes them drink the milk more slowly, which helps with their digestion.
• Make sure their clothes are not too tight, as this can make it uncomfortable for them to properly digest their feed.
• After each feed, try and keep your baby still. It’s often instinctive to bounce babies a little bit; we know they love it, but if they’ve got a tummy full of milk, this won’t help!

For the most part, reflux in babies is nothing to worry about. However, the following signs might indicate that it’s more than just your baby bringing up milk, so you should consult your doctor and seek treatment if your baby:
 

• Has frequent reflux.
• Is arching their back during or after a feed, or drawing their legs up to their tummy after feeding.
• Is unhappy during or after feeds.
• Is losing weight or not putting on enough weight.
• Is vomiting large amounts of milk up to two hours after feeding on a regular basis.
• Starts to cry, fuss or refuse feeds, but will suck on a dummy when offered one.