Reflux in babies

Reflux usually starts before a baby is 8 weeks old and gets better by the time they're 1.

Symptoms of reflux in babies include:

  • bringing up milk or being sick during or shortly after feeding
  • coughing or hiccupping when feeding
  • being unsettled during feeding
  • swallowing or gulping after burping or feeding
  • crying and not settling
  • not gaining weight as they're not keeping enough food down

Sometimes babies may have signs of reflux but will not bring up milk or be sick. This is known as silent reflux.

It's common for a baby under the age of 1 to bring up a little bit of milk during or shortly after a feed, without being distressed. Your baby does not usually need to see a doctor if they have reflux, as long as they're happy, healthy and gaining weight.

If symptoms of reflux seem to be bothering your baby, there are things you can do to help.

Do

  • ask a health visitor for advice and support

  • get advice about your baby's breastfeeding position or how to bottle feed your baby

  • hold your baby upright during feeding and for as long as possible after feeding

  • burp your baby regularly during feeds

  • make sure your baby sleeps flat on their back (they should not sleep on their side or front)

Don't

  • do not raise the head of their cot or Moses basket

See a GP if your baby:

  • is not improving after trying things to ease reflux
  • gets reflux for the first time after they're 6 months old
  • is older than 1 and still has reflux
  • is not gaining weight or is losing weight

Ask for an urgent GP appointment or call NHS 111 if your baby:

  • has vomit that's green or yellow, or has blood in it
  • is projectile vomiting (being sick with more force than usual)
  • has blood in their poo
  • has a swollen or tender tummy
  • has a very high temperature or they feel hot or shivery
  • keeps being sick and cannot keep fluid down
  • has diarrhoea that lasts for over a week or has signs of dehydration
  • will not stop crying and is very distressed
  • is refusing to feed

Also call your GP or 111 if you have any other concerns about your baby.

A GP or specialist may want to check whether your baby has an allergy to cow's milk, because the symptoms can be very similar to reflux. If there's no sign of cow' milk allergy, they may recommend treatments for reflux.

If your baby is formula-fed, they may recommend:

  • a powder that's mixed with formula, to thicken it
  • a pre-thickened formula milk

If the thickening powder does not help or your baby is breastfed, a GP or specialist might recommend medicines that help with distress from reflux and stop their stomach from producing as much acid.

Very rarely, surgery might be needed to strengthen the muscle that stops food or milk travelling back up. This is usually only after trying other things or if their reflux is severe.

Reflux usually happens because the ring of muscle inside your baby's food pipe (oesophagus) can be weak, which allows milk to come back up easily.

This muscle will get stronger as your baby gets older and the reflux should stop.