Normal Presentation 

• Some reflux – regurgitating or vomiting of feeds – is normal in babies

• Reflux is very common. It affects at least 4 out of 10 of babies younger than 1 year.

• Usually no tests or treatments are needed.

• It tends to start before the baby is 8 weeks old.

• Babies can bring up milk 6 or more times a day.

• It normally happens less often as the baby gets older.

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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:

• 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.

 

When to seek medical advice

• The vomiting becomes more forceful, as 'projectile vomiting' contact your GP or 111 out of hours immediately.

• 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.

• 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

• 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:

• gastro-oesophageal reflux disease (GORD) – a long-term form of reflux where stomach contents are able to rise up and irritate the oesophagus

• 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.

• 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

• 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:

• Alginates – these form a protective barrier over stomach contents, stopping them traveling up and irritating the oesophagus

• 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.

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Feeding advice

• Your midwife or health visitor may want to check how you feed your baby and suggest some changes to help with their reflux.

• These changes might include:

• burping your baby regularly throughout feeding.

• giving your baby smaller but more frequent feeds.

• holding your baby upright for a period of time after feeding.