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Identify the signs of infant reflux
Reflux and regurgitation are medical terms used to describe the process of bringing up small amounts of milk after a feed. It’s perfectly normal for babies and thought to be related to their developing digestive system1 – that’s what all those muslin cloths are for! In most cases, there’s absolutely nothing to worry about1. The usual cause is that the valve that keeps the stomach’s contents down is still developing and allowing milk, and acid, to move back up. By your baby’s first birthday most reflux and regurgitation symptoms should be starting to disappear.
What is reflux?
Also known as gastro-oesophageal reflux (GOR), this is where milk, or food in older babies, goes back up from the stomach and into the oesophagus – or food pipe2. Often called ‘silent reflux’, it can sometimes be tricky to work out what’s going on because you can’t physically see what’s being brought back up.
What is regurgitation?
More commonly known as posseting or spitting up, this is where the milk, or food, makes its way from the stomach, through the food pipe all the way into the mouth – and then sometimes out of the mouth, often landing on mum or dad’s shoulder! Unlike vomiting there’s no straining involved – it’s effortless, more like a hiccup2.
The main thing to remember is that although it can be distressing for parents, reflux and regurgitation are both very common and completely normal. You may worry that your baby isn’t getting enough nutrients, but this is very rarely the case. As long as your baby’s not showing signs of discomfort or losing weight, there shouldn’t be a problem.
Around 30% of healthy babies experience infant reflux and regurgitation, several times a day, in the first year of life, while their digestive system is still maturing3,4.
Reflux happens when the valve at the base of your baby's food pipe has not fully developed yet, so milk can come back up easily. There are a number of other factors which may also play a part in the development of reflux:
- Babies spend a lot of their time lying down.
- Their diet is mostly made up of fluid.
- They have a short food pipe.
- Their digestive system is still maturing.
- Too much milk or food in one go may cause a problem.
Most of these causes are part and parcel of being a baby. But there are some simple things you can do to try and ease uncomfortable symptoms if they have been diagnosed with reflux or regurgitation.
Symptoms are usually seen between 3 weeks and 12 months of age5. Your baby is considered to have regurgitation if they ‘posset’ two or more times a day for three or more weeks but have no other obvious signs of illness such as retching, vomiting, weight loss or feeding difficulties6. However, as well as regurgitated milk, there are other unpleasant symptoms associated with reflux2,5:
Constant or sudden crying
Irritability or pain
Waking up frequently
An arched back after feeding
The peak time for symptoms is around 4-6 months and babies normally start to grow out of them between 6-12 months7. While you can’t ‘cure’ reflux or regurgitation, there are practical ways you can help your baby to feel more comfortable until they naturally grow out of it. And it’s good to know our Careline professionals are on hand 24 hours a day, 7 days a week if you need a sympathetic ear or some sound advice. Just call: 0800 996 1000.
Weaning babies with reflux
When it comes to weaning, it’s important to let your baby lead they way - they’ll show signs that they’re ready - but you should wait until they’re around six months old. At first, weaning is about introducing the idea of eating and trying a variety of different tastes and textures, rather than consuming large quantities of food. While your baby is getting used to eating food, keep going with your usual breastfeeding or formula feeding routine. Start off with puréed or blended foods and then move on to mashed or finger foods. Your baby may gag when you introduce solid foods, but this is because they’re figuring out how to chew and swallow. The most important thing is to be patient6.
What is gastro-oesophageal reflux disease (GORD)?
In severe cases, reflux leads to inflammation in the digestive system which can cause feeding problems and ‘failure to thrive’. This is called gastro-oesophageal reflux disease (GORD). It’s not the same as simple reflux and regurgitation and it only happens in severe cases4.
Should I talk to a healthcare professional?
While reflux and regurgitation are normal and should pass with time, it’s always a good idea to talk to your health visitor, pharmacist or GP if you think your baby may have either. Once diagnosed, your healthcare professional will be able to advise on practical ways you can ease the symptoms and, if appropriate, talk you through the nutritional solutions available. Always speak to a healthcare professional if your baby is vomiting regularly, bringing up large amounts of milk or has discomfort while feeding, so other causes can be ruled out. If your baby is less than a year old, our Baby Symptom Checker is a useful way to capture your baby's symptoms for this discussion, and it offers some practical advice too.
- Check whether your baby's symptoms match those we’ve listed.
- Make a note of your baby's symptoms and how often they occur, or enter them into our Baby Symptom Checker and create a PDF summary.
- Talk to your health visitor, local pharmacist, or book an appointment with your GP.
- If your baby is diagnosed with reflux or regurgitation, take a look at our tips for managing the condition.
- Salvatore S et al. Acta Pediatr 2018;107(9):1512-1520.
- NHS. Breastfeeding Challenges - Reflux [Online]. Available at: https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/reflux/ [Accessed Sept 2020].
- Vandenplas Y et al. J Pediatr Gastroenterol Nutr 2016;61(5):531-537.
- NICE. Gastro-oesophageal reflux disease in children and young people: diagnosis and management [Online]. 2015. Available at: https://www.nice.org.uk/guidance/ng1 [Accessed Sept 2020].
- NHS. Reflux in babies [Online]. 2019. Available at: https://www.nhs.uk/conditions/reflux-in-babies/ [Accessed Sept 2020].
- Hyman PE et al. Gastroenterol 2006;139:1519-1526.
- Nelson SP et al. Arch Pediatr Adolesc Med 1997;161(6)659-572.
Questions about feeding and nutrition?
Our midwives, nutritionists and feeding advisors are always on hand to talk about feeding your baby. So if you have a question, just get in touch.