What is and What Causes Reflux in Babies

What is Baby Reflux?

Baby reflux is basically the same as adult reflux.  Reflux happens when the stomach contents don’t stay within the stomach.  Instead, they regurgitate up into the oesophagus (food pipe) and sometimes, into the baby’s mouth.  

The correct name for reflux is Gastro-oesophageal reflux, or, GOR. Most of the time we just say “reflux”.  

What Causes Reflux?

A baby’s gut is immature. Just like the rest of their body, growth over time increases the size of their stomach and the way their body functions.  The muscles involved in keeping milk down and within the stomach can be lax and the sphincter at the top of the baby’s stomach more open than it could be. This combination of muscle relaxation and an open inlet means that milk easily refluxes back up into baby’s oesophagus.

The shortness of a baby’s oesophagus and distance between their mouth and their stomach means that reflux is common.

How Would I Know if My Baby Has Reflux?

First Remember, all babies reflux, especially in the first few months of life.   Some are more troubled by reflux symptoms than others. There is no one consistent way in which reflux affects all babies.

Vomiting or spitting up milk - sometimes this is just a small ‘spill’, known as a possit. Occasionally they bring up bigger volumes of milk. When a baby spills it can look as if they’ve vomited most of their feed. Liquid has a tendency to spread, sometimes far and wide. What can look like a big volume may only be a few millilitres. Babies with reflux can vomit during, after and between feeds. 

    Gastro-oesophageal reflux disease (GORD)

    Gastro-oesophageal reflux disease, also known as ‘GORD’, can occur in babies whose reflux is more severe.  A baby is diagnosed with GORD when their reflux is no longer within a normal range and is causing the baby more discomfort.

    Symptoms of GORD can include pain in the baby’s chest or stomach, back arching and/or more frequent vomiting.  Sometimes GORD causes issues with weight gain and impacts on the baby’s contentment.

    GORD can cause:

    • Changes in sleep and settling behaviour
    • Weight loss
    • Vomiting and blood to appear in the baby’s vomit
    • A chronic cough or wheeze
    • A lack of enjoyment for parents caring for their baby. When GORD symptoms result in long hours of crying, frequent vomiting and little respite, GORD can take a toll on the most patient and loving of parents.

    How Can I Manage My Baby’s Reflux?

    • Comforting strategies are generally helpful. Rocking, soothing, shshing, and holding close often help. Some parents find that keeping their baby upright after feeding also helps to lessen positing.
    • Parents may also find that elevating their baby’s change table is helpful.
    • When a baby is experiencing pain from reflux, sometimes an antacid medication is recommended. Other reflux medications work by changing the pH of the stomach acid or hastening the time the stomach takes to empty.

    What Shouldn’t I Do When My Baby Has Reflux?

    You need to always follow safe sleeping recommendations. Healthcare experts are clear that the safest way for a baby to sleep is on their back.

    What If My Baby Vomits When They Are Lying Flat?

    Back sleeping is actually protective if a baby vomits. Healthy, well babies who sleep on their back are less likely to choke on their vomit than babies who sleep on their tummy or their side. This is because the upper respiratory airways are positioned above the oesophagus, not underneath it. 

    Will My Baby Grow Out of Reflux?

    Most babies with reflux grow out of it without any specific treatment.  By the toddler years, it’s unusual to still see children troubled by reflux symptoms. 

    Gravity plays a big part in alleviating reflux symptoms.  Once a child is upright and sitting, no longer spending long hours on their back or tummy, reflux tends to no longer be an issue.

     

    Should My Baby with Reflux See a Doctor?

    If you are worried about any aspect of your baby’s health always speak and check with a qualified nurse or healthcare professional about your baby's well being.

    Have your baby checked if:

    • They’re having problems swallowing
    • Vomiting after every feed
    • Vomiting blood or bile
    • They’re not gaining weight
    • They have a fever or seem unwell
    • They are unhappy or miserable a lot of the time
    • They’re not feeding or, they fuss during their feeds

    Top Five Tips for Gastro-oesophageal Reflux

    1. The majority of babies grow out of their reflux without any special treatment or care.
    2. Sometimes upright feeding helps and keeping them upright for around 30 minutes after they’ve finished feeding. More frequent burping and aiming not to overfeed can also make a difference.
    3. It’s important to follow your baby’s hunger cues as a sign for when they’re ready to feed.
    4. Position your baby in a sling or pouch if they’re fussing.
    5. Keep an absorbent bib or towelling cloth nearby, especially after your baby’s fed.

    Remember

    Always speak and check with a qualified nurse or healthcare professional about your baby to understand what your baby’s individual needs are, especially if you are ever concerned about your baby's well being.