What to Know About Infant Reflux

If you’ve spent any time with an infant you know: Babies spit up—often many times a day. Officially, spitting up and regurgitating (when contents of the stomach come back up the esophagus  into a baby’s mouth) is called gastroesophageal reflux (GER). In babies, it’s sometimes called infant reflux, and for good reason: An estimated 70-85 percent of infants regurgitate daily by the time they are two months old.

What Causes Infant Reflux?

For the most part, reflux is fairly normal in infants. It’s just a sign that the muscle between your baby’s stomach and esophagus, called the lower esophageal sphincter (LES), is not yet fully developed. For this reason, GER is more likely in premature babies, whose LES is generally even less developed than in full-term infants. 

Two very common facts of babyhood also make reflux more likely: lying flat for long periods of time and consuming an all or nearly all liquid diet. Note that these facts should not cause you to change their back-sleeping routine or give them solid foods. Always follow your pedatrician’s recommendations regarding sleeping and when to introduce solid foods. 

While reflux is quite common in infants, by the time your baby is 12 to 24 months old, they will likely outgrow this condition. 

Common Symptoms of Reflux

Typically, if your baby appears generally healthy and seems largely unbothered by spitting up, there may be little cause for concern. These symptoms are common in infant reflux:

  • Spitting up without effort or pain
  • Spitting up just 1 or 2 mouthfuls at a time
  • Burping with some spit-up (wet burps)

Symptoms That May Cause Concern

If your baby has any of these symptoms, consult with your pediatrician. 

  • Choking on spit-up milk
  • Projectile vomiting
  • Low or no weight gain
  • Blood in the stool
  • Low energy
  • Irritable after eating
  • Refuses to eat
  • Reflux starts at age 6 months or later

The above symptoms are not typical of infant reflux and may indicate other issues, such as a food intolerance, pyloric stenosis (where a thickened valve prevents food from leaving the stomach to the small intestines), eosinophilic esophagitis (where white blood cells build up and attack the lining of the esophagus) or gastroesophageal reflux disease (GERD). Your doctor can properly diagnose these or any other underlying conditions. 

How to Manage Infant Reflux

Generally, doctors don’t recommend or prescribe medicine for babies with infant reflux. But there are some at-home strategies you can use to minimize reflux in your little bub. Try one or more of these to ease discomfort and reduce reflux frequency: 

  • Feed baby in an upright position—and keep them upright for 30 minutes following feeding. In this way, you’re getting help from gravity to keep their food down. 
  • Feed your baby smaller meals more often. Overall, they should still be eating the same amount. 
  • Burp your baby during and after feeding. The goal is to minimize air in the stomach. 
  • Stash burp clothes in your home, car, and diaper bag. This way you’ll never be caught off guard!