What is reflux and what causes it?

Reflux is when your baby is sick during or after a milk feed. Most babies are sick at least occasionally, and even if your little one is bringing milk back up more frequently it’s usually not something you need to worry about.
Reflux is very common with at least four in 10 babies suffering from it.   Most babies grow out of it by their first birthday.

We all have a ring of muscle between our stomach and oesophagus (food pipe).  In many babies this ring is immature and not very strong.  This means that milk can leak back out of your baby’s stomach, up their oesophagus and out of their mouth. Babies with a low birth weight and premature babies are more prone to reflux.  It is also more common in babies with cerebral palsy and other muscle/nerve impairments and babies with a cows milk allergy.

Reflux usually starts before your baby is eight weeks old and reduces after they reach six months. In 9 out of 10 babies it will have resolved itself by 12 months.

 

Does my baby have reflux – what are the symptoms?

The main symptoms of reflux are:

• Frequently bringing up milk during or just after a feed.
• Being unsettled during feeds or fighting feeds.
• Choking or coughing during feeds.
• Frequent hiccups.
• Slower than expected weight gain.
• Being unsettled between feeds.

Some babies show all the signs of having reflux other than spitting up milk and slow weight gain, this is called silent reflux.  Rather than spitting the regurgitated milk out they swallow it again.

 

What can I do to help ease my baby’s symptoms?

If your baby seems to be showing signs of reflux there are a few things you can try to ease their symptoms:

• Feed your baby in a more upright position.  Whether you’re bottle feeding or breastfeeding make sure your baby’s bottom is lower than their head during the feed.
• Use gentle burping techniques both at the end of, and regularly during, feeds.
• If you’re bottle feeding give smaller amounts of milk more frequently (the same total amount over the course of a day).
• Keep your baby in an upright position for as long as possible after a feed.
• If your baby is formula fed you could try a thickened ‘anti-reflux’ milk.  Get advice from your health visitor before switching.

Caution!

If your baby has reflux you might get well meaning advice from friends and family to raise the head end of their cot or Moses basket, put a wedge pillow or rolled towel under the mattress, let them sleep in a bouncy chair or car seat, or even to put them to sleep on their side or tummy to ease symptoms. There is no evidence to suggest any of these techniques help with reflux.  However they are not safe sleep positions which may increase your baby’s risk of SIDS. Even with reflux the safest sleeping position for your baby is flat on their back on a firm mattress.

What next?

If you have tried all the tips above but your baby is still bringing up a lot of their feeds and seems to be in pain it’s worth chatting to your GP, they may prescribe some medication to reduce the reflux and help your baby feel more comfortable.
You should also see your GP if your baby:

• Is not gaining – or is losing – weight.
• Has only started exhibiting signs of reflux after 6 months of age.
• Is still suffering from reflux after 12 months of age.
• Has a swollen tender tummy.
• Has green or yellow vomit, or blood in their vomit.
• Is frequently projectile vomiting.
• Has blood in their poo.
• Has diarrhoea that lasts more than 7 days or is becoming dehydrated.
• Is very distressed and/or crying excessively.
• Is refusing feeds.

While reflux might result in more laundry, it is a very common and pretty normal thing for babies to experience. As long as your little one is gaining weight and is generally happy it really isn’t anything to worry about.  They will soon grow out of it as their digestive system matures, and in the mean time the tips above should help.

If your baby has reflux, or you think they might have it, you can ask questions and get support from other parents in our Forum.