What is reflux?
Reflux is when the contents of the baby’s stomach, and that might be milk or acid, come up the oesophagus towards the baby’s mouth.
Most babies have a little bit of reflux because the valve at the end of their food pipe, which is like a door down to the stomach and designed to keep the food down, hasn’t developed fully yet. So lots of babies do something called ‘posseting’, which means a little bit of milk comes back up when they burp. This is normal and very common.
However, when strong acid comes back up from the baby’s stomach it isn’t normal and can be very painful for them. The valve door gets stronger through the first year, so the chances of the reflux going away naturally do increase as the baby grows.
When babies have reflux, it really burns, is very painful and can be very distressing for the baby. It’s something you usually see in younger babies who are exclusively milk fed and who spend more time lying down. It gets less of a problem as babies sit up more and go on to solid feeds that sit more easily in the stomach.
Is reflux common in babies?
Around 50% of all babies have it to some degree during the first three months, but it will be a problem for only a small minority. By the age of 10 months, the number of babies with reflux drops to around 5%, as the valve door strengthens and holds stomach contents firmly down.
What are the symptoms of reflux in babies?
Signs of reflux in babies include:
- Pain or discomfort when feeding, such as arching his back, refusing milk and crying
- Frequently vomiting or spitting up milk (more than normal posseting, which is only about a teaspoon)
- Coughing frequently, including at night, but with no sign of a cold
- Waking often at night, especially about 45 minutes after they fall asleep, which is shorter than a full sleep cycle
- Low weight gain or even weight loss
- Silent reflux is harder to spot as your baby may not bring up their milk feed. However, they may appear to be in pain when they are not upright and have a persistent cough
How can I prevent reflux in my baby?
Feed little and often, so your baby’s tummy doesn’t get too full. Some parents find it helpful to prop their baby up at a 45° angle after a feed either in a baby chair or just holding them sitting to allow the milk to settle into the stomach. Try this for at least half an hour after each feed – longer for formula milk since it takes longer to digest.
Some parents find it also helps to prop the head end of the baby’s cot up a bit on some bricks so that the baby’s head is slightly raised compared to the rest of the body. Avoid tight clothing on your baby – particularly clothing that is tight around the baby’s tummy, since this helps push the stomach contents back up.
If you notice that your baby is distressed in certain postures, it can help to carry your baby in a sling that keeps them comforted and upright. Also, try to minimise time in car seats or prams where they can slump into an uncomfortable position.
Some parents have found that gentle massage can help – see the section on Baby Massage in The Care & Development section of the Essential Baby Care Guide. We show good basic techniques, all recommended by a paediatric physiotherapist.
What should I do if I think my baby has reflux?
If you think your baby is showing signs of reflux, and the ideas above aren’t helping, you should take them to be assessed by your GP. More serious reflux is easily treatable with medication, so if your baby does seem to be unduly distressed on a regular basis then it’s certainly something to think about and investigate.