- Infant reflux occurs when milk travels back up from a baby’s stomach, causing spit-up or discomfort.
- Common signs include hiccups, frequent spit-up, coughing, irritability after feeds, and back-arching.
- Reflux is usually caused by an immature digestive system, swallowing air, lying flat after feeds or overfeeding.
- Most reflux is normal, but signs like weight issues, refusal to feed, forceful vomiting, or blood in vomit require medical guidance.
- You can help soothe reflux by feeding upright, burping often, keeping your baby upright after feeds, and using a slow-flow teat or paced feeding.
- Some babies may need smaller, more frequent feeds to prevent overfilling the stomach.
Reflux is when a baby brings up milk, or is sick, during or just after a feed. It's normal for most babies (which is why all those bibs come in handy) and usually gets better, without causing any significant problems.
What causes reflux in babies?
Reflux happens because the muscles at the bottom of baby's oesophagus (food pipe) and stomach are not fully developed, so rather than going into their tummy, milk and food can sometimes travel back up. As your baby grows, these muscles develop and your baby stops getting reflux.
Reflux usually starts before your baby is 8 weeks old and gets better by the time they reach their first birthday.
Signs of reflux in babies
Your baby may show that they are distressed and uncomfortable in many different ways. It's not always reflux that's causing their pain. They may be feeling hot, cold, want a change or just a cuddle. But signs of reflux include:
- Baby bringing up milk or being sick during or shortly after feeding
- Baby coughing or hiccupping when feeding or seeming to have a sore throat
- Baby being unsettled during feeding
- Baby swallowing or gulping after burping or feeding
- Baby arching their back and turning their head
- Fighting feeding or refusing to feed
- Crying for long periods and becoming upset during and after feeds
- Persistent hiccups
- Not gaining weight as they're not keeping enough food down
What causes infant reflux?
Infant reflux is usually caused by an immature lower oesophageal sphincter (the muscle that keeps stomach contents down).
Other contributing factors include swallowing air during feeds, lying flat after feeding, overfeeding, or sensitivity to certain foods in breastmilk or formula.
What is silent reflux?
Regular reflux happens when your baby spits up milk after feeding. Sometimes babies don't spit out what comes back up but swallow it instead. This is known as 'silent reflux'. Babies with silent reflux might gain weight normally but show some of the other signs of reflux.
With silent reflux, when your baby brings up milk, some of the acid from their tummy will come with it, making your little one uncomfortable and restless after feeding.
If you notice your baby swallowing after a feed, when there shouldn't be milk in their mouth, they may have silent reflux. Your baby may develop a cough and will often show signs of discomfort when lying down.
When is infant reflux not “normal”?
Reflux becomes a concern when it affects:
- Comfort
- Feeding ability
- Sleep
- Breathing
- Weight
This may indicate GORD (gastro-oesophageal reflux disease), which requires medical input and sometimes medication.
Tips to help a baby with reflux
- Gently burp your baby regularly while feeding
- Take breaks during a feed
- Give your baby shorter but more frequent feeds
- Hold your baby in a more upright position during feeding. Generally the advice is to keep their head higher than their bottom during feeds
- Keep your baby upright for 20-30 minutes after feeding
- Change your baby on their side to avoid any discomfort caused by lifting their legs towards their stomach
Top tip
If you're using formula to feed your baby, you can use thickened 'anti-reflux' formula milk. But it's important to talk to your GP or a healthcare professional before you try this as thickened milk can swap reflux for constipation.
Baby bottles that can help with reflux
Choosing the right bottle can make a noticeable difference for babies with reflux. Our Advanced Anti-Colic™ bottle is designed to reduce the amount of air your baby swallows during feeds which is a key trigger for reflux symptoms.
The patented vented wand and silicone valve draw air away from the tummy, helping milk flow smoothly while minimising trapped wind, discomfort and spit-ups.
An anti-colic system can ease feeding fussiness and support more settled feeds overall.
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Are some babies more inclined to get reflux than others?
Reflux can be more common among babies who are born prematurely and babies who had a low birth weight. Babies and children who have an allergy to cow's milk may are also more likely to develop reflux.
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Will it help with reflux if we switch from breastfeeding to formula?
Babies who are breastfed and formula fed can both get reflux. But it's generally accepted that breast milk is easier for babies to digest, one of the many reasons it is recommended that you breastfeed your baby.
If your baby is formula fed and develops reflux, you can try giving them smaller feeds more often and talk to a health professional about the best kinds of formula milk to feed your baby.
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When should you seek medical advice for reflux?
You should seek professional medical advice if your baby:
- Is not improving after 2 weeks of trying things to ease their reflux
- Gets reflux for the first time after they're 6 months old
- Is more than 1-year-old and still gets reflux
- Is not gaining weight or is losing weight
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When does infant reflux stop?
Infant reflux usually begins to ease once the digestive system matures and the baby spends more time upright.
Most babies show noticeable improvement by 4-6 months.
Then, for some, reflux resolves by 9-12 months as they begin sitting, standing, and eating solids, which all help keep food down.
In a small number of infants, symptoms may continue beyond the first year. In these cases, this should be discussed with your doctor.
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How to cure reflux in infants
Typically this cannot be ‘cured’ because it’s caused by the immaturity of the baby’s digestive system. It usually improves naturally with time as the valve between the stomach and oesophagus strengthens.
You can, however, significantly reduce symptoms with feeding adjustments, upright positioning and burping techniques.
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Can I continue breastfeeding if my baby has reflux?
Absolutely. Adjusting feeding positions and latch can help significantly.
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Can certain formulas help?
Some babies may benefit from thicker or specialist formulas; always seek advice from your GP first.
