Your baby brings up milk after nearly every feed, sometimes cries and arches while feeding, and you go through bibs by the dozen. Baby reflux, also called gastro-oesophageal reflux (GER), is very common because the muscle at the top of the stomach is still developing. In most babies it is harmless and improves with time. Here is how to tell normal reflux from something more, and what helps.
Quick answer: baby reflux
- Very common: up to half of babies spit up regularly in the first months.
- Usually harmless if your baby is gaining weight and generally content.
- Often improves by 6 months and has usually gone by 12 to 18 months.
- GERD (reflux disease) is when reflux causes problems such as poor weight gain, feeding refusal or breathing issues.
Symptoms of reflux
- spitting up or bringing up milk during or after feeds
- coughing or hiccups during feeds
- fussing, crying or arching the back during feeds
- swallowing or gulping after feeding
Signs that may mean GERD
- poor weight gain or weight loss
- refusing feeds or feeding for very short periods
- frequent coughing, wheezing or chest infections
- crying a lot and seeming in pain
- blood in vomit or poo
Tips that may help
- Feed in an upright position and keep your baby upright for 20 to 30 minutes afterwards. See baby feeding positions.
- Offer smaller, more frequent feeds.
- Burp often during feeds.
- Check the latch or teat flow to reduce swallowed air.
- Avoid tight clothing and nappies around the tummy.
- Keep a smoke-free home.
Safe sleep with reflux
Always lay your baby on their back to sleep, on a flat surface. Do not raise the mattress or use wedges or positioners; they are not recommended and can be unsafe. Healthy babies protect their airway when they spit up. See safe sleep practices.
Treatment
Most babies need no medicine. If your doctor suspects GERD or cow’s milk protein allergy, they may suggest feed thickeners, a change in formula, or a trial of avoiding dairy if you breastfeed. Acid-reducing medicines are only used in specific cases.
When to talk to your doctor
- forceful (projectile) vomiting, especially in babies 2 to 8 weeks old
- green or yellow vomit, or blood in vomit or poo: seek urgent help
- poor weight gain, or fewer wet nappies
- breathing difficulty, or repeated chest infections
- vomiting starting after 6 months, or with fever
- reflux that continues past 12 to 18 months
Frequently asked questions
Does reflux cause colic?
They can look similar, but most crying babies do not have reflux. See the colic survival guide.
Should I switch formula?
Only after talking to your doctor.
Is silent reflux real?
Some babies show reflux signs like discomfort and swallowing without bringing milk up. Talk to your doctor if your baby seems distressed.
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Sources
- NHS: Reflux in babies
- NICE: Gastro-oesophageal reflux disease in children and young people
- American Academy of Pediatrics, HealthyChildren.org: GERD and Reflux in Infants
This guide is general information, not medical advice. If you are worried about your baby’s reflux, talk to your doctor.