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27/03/2021
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Noticed your baby spitting up a little after feeds? This is known as reflux and can occur in up to 40% of newborns for completely normal physiological reasons.

What is Reflux 

Gastro-oesophageal reflux (GOR) is when the baby brings milk back up during or after feeding via their oesophagus. This can happen several times a day and can be referred to as posetting, where less than a teaspoon of milk comes up and causes no discomfort to the child.  

In some cases, the reflux can cause discomfort to a child and this is known as GORD – gastro-oesophageal reflux disease. This is more long-term and causes the food pipe to become sore and inflamed. 

Related: How I Coped With My Child’s Reflux

Causes of Reflux in Infants

Acid reflux can happen as the muscle that connects the food pipe to the stomach has not fully developed yet in infants. This can mean that in some cases, the muscle opens when it shouldn’t – usually when their stomach is full – and the food (milk) and stomach acid can come back up. 

Your child may be more likely to suffer from reflux if they:

  • were born prematurely 
  • had a low birth weight
  • have a cow’s milk allergy 
  • have a neurodisability

Signs and Symptoms of Reflux

Here are the signs and symptoms of reflux that your baby may have:

  • Feeling unsettled during feeding
  • Arching their back and turning their head
  • Waking up frequently at night
  • Crying and not settling down
  • Weight loss or poor weight gain
  • Frequent ear infections
  • Hiccups or coughing
  • Refusing or gagging during feeds 

The signs of reflux tend to show before the child is 8 weeks old and the symptoms should alleviate before they are one. In some cases, your child may suffer from silent reflux where the child is showing symptoms of reflux but they are not bringing anything back up.  

Related: 5 Things You Need to Know About Your Newborn’s Tummy

Treatment of Reflux

Whilst it may seem distressing to the parent, reflux is usually nothing to worry about as long as the baby is gaining weight and is healthy.

It is recommended to alter some of your baby’s feeding habits at home first before seeking medical advice. This can include:

  • Adjusting your baby’s feeding position
  • Burping your baby throughout feeding
  • Giving smaller and more frequent feeds 
  • Holding your child upright during and after feeding 
  • Making baby sleep flat on their back

If, however, your child is not gaining weight, has reflux for the first time after 6 months, the reflux continues beyond a year or after two weeks, there is still no improvement after altering baby’s feeding habits at home, it is best to see a GP who can suggest a few treatments. 

If your baby is on formula milk, you may be given:

  • a pre-thickened formula milk
  • a powder that you mix into the formula milk to make it thicker

If you are breastfeeding your child, you may be given a feed thickener that you add to expressed breast milk or mix with water and feed to the child with a spoon before breastfeeding. 

If your child does not respond well to the above milk thickeners, they may be prescribed medication to decrease the amount of acid that their stomach is producing. 

Surgery is a last-resort option in extreme cases where the reflux is severe and the medication has not helped or the child has underlying health conditions. This will be done to help strengthen the muscle at the bottom of the child’s food pipe. 

What Happens Next

Reflux tends to resolve on its own in 90% of cases as the baby becomes older and their digestive system has now matured. They also spend more time being upright as they learn to sit. 

References

  1. https://www.nct.org.uk/
  2. https://www.ruh.nhs.uk/
  3. https://www.nhs.uk/

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