Baby Health Clinic
Frequently Asked Questions Parents have about their Baby
Infant Reflux
Gastro-oesophageal reflux in Infants
How to Treat and Prevent Infant Reflux?


Normal Presentation
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Some reflux – regurgitating or vomiting of feeds – is normal in babies
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Reflux is very common. It affects at least 4 out of 10 of babies younger than 1 year.
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Usually no tests or treatments are needed.
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It tends to start before the baby is 8 weeks old.
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Babies can bring up milk 6 or more times a day.
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It normally happens less often as the baby gets older.
Check if your baby has reflux
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:
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bringing up milk or being sick during or shortly after feeding
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coughing or hiccupping when feeding
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being unsettled during feeding
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swallowing or gulping after burping or feeding
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crying and not settling
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not gaining weight as they're not keeping enough food down
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Sometimes babies may have signs of reflux but will not bring up milk or be sick. This is known as silent reflux.
When to seek medical advice
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The vomiting becomes more forceful, as 'projectile vomiting' contact your GP or 111 out of hours immediately.
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If your baby brings up milk that is green, yellow‑ish green or if it looks as though it has blood in it, contact your GP or 111 out of hours immediately.
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If your baby, won't stop crying (high pitch cry after vomiting), arching their back during or after a feed, or drawing their legs up to their tummy after feeding, stops putting on weight, or if reflux is still a problem in a baby older than 1 year.
Causes
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It's normal for some babies to have reflux. It usually just occurs because a baby's food pipe (oesophagus) is still developing. It normally stops by the time a baby is a year old, when the ring of muscle at the bottom of their oesophagus fully develops and stops stomach contents leaking out. In a small number of cases, reflux can be a sign of a more serious problem, such as:
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gastro-oesophageal reflux disease (GORD) – a long-term form of reflux where stomach contents are able to rise up and irritate the oesophagus
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a cows' milk allergy – this can also cause a rash, vomiting and diarrhoea; many babies will eventually grow out of it and can be treated by removing cows' milk from their diet.
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a blockage – rarely, reflux may occur because the oesophagus is blocked or narrowed, or there's a blockage in the stomach and small intestine.
Medication
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Babies with reflux don't usually need to take any medication, but sometimes the following medicines may be offered if your doctor feels the problem is severe:
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Alginates – these form a protective barrier over stomach contents, stopping them traveling up and irritating the oesophagus
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Proton pump inhibitors (PPIs) and H2-receptor antagonists – these reduce the level of acid in the stomach, so the stomach contents don't irritate the oesophagus as much.
Feeding advice
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Your midwife or health visitor may want to check how you feed your baby and suggest some changes to help with their reflux.
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These changes might include:
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burping your baby regularly throughout feeding.
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giving your baby smaller but more frequent feeds.
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holding your baby upright for a period of time after feeding.
DHD Reviewed 2021 National Health Service 2023. National Health Service Choices 2.3.23 https://www.nhs.uk/conditions/reflux-in-babies/
National Institute for Excellence in Health and Care (NICE) 1.3.2019 Gastro-oesophageal reflux disease in children and young people: diagnosis and management
https://www.nice.org.uk/guidance/ng1/ifp/chapter/Medicines-to-reduce-acid-production2018 surveillance of gastro-oesophageal reflux disease in children and young people: diagnosis and management (NICE guideline NG1)