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Reflux and regurgitation
Reflux and regurgitation are when your baby brings up small amounts of milk after a feed. It’s perfectly normal. In fact, around 30% of healthy babies experience regurgitation during their first year, while their digestive system is still maturing1.
Read on to learn about the signs and symptoms to look out, what causes reflux and regurgitation, and how to relieve it.
What is reflux or acid reflux in babies?
Reflux (or acid reflux) in babies is when milk goes into your baby’s stomach, but then comes back up into their oesophagus – or food pipe2. This is referred to as gastro-oesophageal reflux. If it becomes painful and happens frequently it’s known as gastro-oesophageal reflux disease (GORD)2.
Regurgitation (also known as ‘posseting’ or ‘spitting up’) is when milk goes into your baby’s stomach, but then comes back up into, or out of, their mouth. Unlike vomiting there’s no straining involved; it’s effortless, more like a hiccup2.
Reflux and regurgitation are both very common and completely normal. You may worry that your little one isn’t getting enough nutrients, but as long as they aren’t showing signs of discomfort or losing weight, there shouldn’t be a problem.
Gastro-oesophageal reflux disease in babies (GORD/GERD)
Gastro-oesophageal reflux disease, (GORD, or GERD in the US), is when your baby experiences prolonged symptoms of acid reflux, which can become troublesome or begin to cause complications.
Silent reflux in babies
Confusingly, some babies suffer from silent reflux3. This is much harder to diagnose because they only bring up a small amount of milk, or don’t spit out what comes back up but swallow it instead. While babies with silent reflux might not appear to bring up their milk, and may even continue to gain weight normally, they may show some of the other symptoms of reflux.
Signs and symptoms of reflux in babies
- Bringing up small or large amounts of milk during and after feeding on a regular basis, with no other obvious signs of illness.
- Coughing or spluttering during feeding and having trouble swallowing milk.
- Crying during and after feeds.
- An arched back during and after feeds.
- Crying suddenly and/or constantly.
- Recurrent hiccups.
- Irritability and unsettled sleep.
What causes reflux in babies?
It makes no difference if your baby is breast- or bottle-fed. Reflux can affect any baby from shortly after birth until their first birthday.
When your baby is born, the oesophagus (the pipe leading from your baby’s mouth to their stomach) isn’t always fully developed. The oesophagus has a valve which closes over the stomach, helping food to stay down and be digested. In newborn babies, this valve may not be quite ready to fully function, meaning that milk and stomach acid occasionally come back up. The good news is that this valve gets stronger during your baby’s first year of life. As this happens, the chances of your baby developing reflux get much, much lower4.
There are other things that can contribute too:
Your baby’s developing digestive system
Feeding is new to your baby and their tiny tummy is still getting used to the sensation and process of eating and feeling full.
Lying down after feeds
If your baby spends a lot of time lying down, with a lot of milk in their tummy it may be harder for them to digest.
Your baby drinking too much at once
This can cause discomfort in their tummy.
Baby reflux management: how to help
While reflux is usually nothing to worry about and generally resolves itself,
there are plenty of things you can do to help:
- Feed your baby little and often – smaller amounts of milk are more manageable for tiny tummies.
- Take your time – babies with reflux don’t cope well if feeding happens too quickly.
- Try to keep your baby upright during and after feeding.
- Try winding your baby before and after feeds.
- Avoid bouncing your baby up and down after a feed.
- Avoid dressing your baby in outfits that are tight around the waist.
- If you’re bottle-feeding, try a slow-flowing teat to stop your baby guzzling their milk and taking in too much in one go.
- You might also want to speak with your GP or pharmacist about the special infant formulas available for babies with reflux.
Taking care of you: Happy mum, happy baby
Coping with reflux is hard. You may feel as though you don’t want to feed your baby anywhere other than at home, where there’s an abundance of muslin cloths and a change of clothes at hand. You may also feel that all you do is feed your baby, because the moment you’re finished they bring it all back up and you have to start all over again. Or you may find yourself worrying that your baby isn’t getting enough nutrients - but rest assured that this is highly unlikely.
It’s completely normal to feel a bit helpless or anxious about your baby’s next feed if your baby is suffering from with reflux. We also know that trusting your instincts is the right thing to do; after all, you know your baby better than anyone else. If you’re concerned about your baby’s weight, or your baby is often bringing up large amounts of milk and appears to be distressed or in pain, talk with your Health Visitor and GP. Together you can look at ways to make feeding time more manageable for you and your little one.
Don’t forget, our dedicated Careline team are at the end of the phone to give you one to one support when you need support and advice, or a friendly ear.
- Vandenplas Y et al. J Pediartr Gastroenterol Nutr 2015;61(5) 531-7
- NHS Start 4 Life. Breastfeeding challenges. [Online]. Available at: https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/reflux/ [Accessed October 2020].
- Vandenplas Y et al. J Pediartr Gastroenterol Nutr 2009;49:498-547.
- NICE. NG1. Gastro-oesophageal reflux disease: recognition, diagnosis and management in children and young people. 2015. Available at: https://www.nice.org.uk/guidance/ng1/resources/gastrooesophageal-reflux-disease-recognition-diagnosis-and-management-in-children-and- young-people-51035086789 [Accessed October 2020].
- NHS. Reflux in babies. [Online]. 2019. Available at: https://www.nhs.uk/conditions/reflux-in-babies/ [Accessed October 2020]
Last reviewed: 18th October 2020
Reviewed by Nutricia’s Medical and Scientific Affairs Team
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