Reflux in Babies

What is reflux?

Reflux is when your baby brings up milk or is sick during feeding or just after. It's very common and usually nothing to worry about. Most babies get better on their own as they grow.

Why does reflux happen?

Your baby has a ring of muscle where their food pipe meets their stomach. In babies, this muscle is often weak, so milk can easily come back up. As your baby gets older, this muscle gets stronger and reflux usually stops.

What are the signs of reflux?

Reflux usually starts before your baby is 8 weeks old and gets better by their first birthday. You might notice:

• Bringing up milk or being sick during or after feeds
• Coughing or hiccupping while feeding
• Being fussy during feeds
• Making gulping sounds after burping
• Crying and being hard to settle
• Not putting on weight properly

Some babies have "silent reflux" - they have the uncomfortable feelings but don't actually bring up milk.

What can you do to help?

If your baby seems bothered by reflux, try these tips:

Do:

• Hold your baby upright during feeds and for as long as possible afterwards
• Burp your baby regularly during feeds
• Make sure your baby sleeps flat on their back
• Ask your health visitor for feeding advice
• Get help with breastfeeding position or bottle feeding technique

Don't:

• Raise the head of their cot or Moses basket

Remember, many babies bring up small amounts of milk without being upset. If your baby is happy, healthy and gaining weight, they probably don't need to see a doctor.

When to speak to your GP

See your GP if your baby:

• Isn't getting better after trying the tips above
• Gets reflux for the first time after 6 months old
• Is over 1 year old and still has reflux
• Isn't gaining weight or is losing weight

When to get urgent help

Call your GP urgently or ring NHS 111 if your baby:

• Has green, yellow or bloody vomit
• Is projectile vomiting (being sick with unusual force)
• Has blood in their poo
• Has a swollen or tender tummy
• Has a very high temperature or feels hot, cold or shivery
• Keeps being sick and can't keep fluids down
• Has diarrhoea lasting over a week or signs of dehydration
• Won't stop crying and seems very distressed
• Is refusing to feed

Trust your instincts - if you're worried about your baby, speak to your GP or call NHS 111.

What treatments are available?

Your GP might check if your baby has a cow's milk allergy, as this can cause similar symptoms to reflux.

For formula-fed babies, they might suggest:

• A powder to mix with formula to make it thicker
• Ready-thickened formula milk

If these don't help, or if you're breastfeeding, your GP might recommend medicines that reduce stomach acid and help with discomfort.

Very rarely, surgery might be needed to strengthen the muscle, but this is only for severe cases.

Remember, most babies with reflux get better as they grow, usually by their first birthday.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.