Reflux is when your child brings the contents of their stomach back up into their food pipe or mouth. They may bring up small amounts of milk along with air when they are burped. Reflux, also called spitting up, posseting or regurgitation, is very common in newborns.
The medical term for reflux is gastro-oesophageal reflux, or GOR. If GOR is more serious or has complications it may lead to gastro-oesophageal reflux disease or GORD.
Reflux occurs because a muscle at the top of the stomach, called the sphincter, is loose. It can also be caused by air bubbles in the stomach or by eating too much food too quickly.
Spitting up may not cause discomfort and your baby may seem not notice.
Reflux is not the same as vomiting. Vomiting is forceful, is usually more than a tablespoon or 2, and upsets the baby. Vomiting can be a sign of illness.
Reflux is not the same as drooling and blowing bubbles, which is especially common once babies start teething.
Spitting up often peaks by 4 months of age and by 7 months many babies no longer do it, although for some it takes longer.
Tips for managing reflux
Here are some things you can do to minimise your baby’s reflux:
- Make each feed calm and relaxed.
- Hold your baby in an upright position, not lying down, while you feed them. Keep your baby upright for 30 minutes after feeding. An infant seat or car seat works well.
- Feed your baby smaller amounts at a time.
- Feed your baby without delay. If the baby has cried for a long time before a feed, they may have swallowed air. Spitting up is more likely if the baby has air in the stomach at the beginning of a feed.
- Check the size of the opening in the teat if you are bottle feeding. The bottle should leak several drops of milk per second. A hole that is too big will let the baby swallow formula too quickly and baby is likely to spit up the excess. A hole that is too small forces the baby to suck very hard and swallow air.
- Burp your baby several times during each feed. It works best to support the infant's head and burp them sitting on your lap. Burping your baby over your shoulder may put too much pressure on their stomach.
- If you are supervising your baby, you can place them on their tummy for an hour or so after the feed. Take care not to let baby sleep on their tummy because of the link with sudden unexpected death in infancy. Always place your baby on their back to sleep.
- Make sure nappies are not too tight and do not put pressure on the baby's stomach.
When to see the doctor about reflux
If your baby is otherwise healthy and happy and they are just bringing up milk, nothing needs to be done. Talk to your doctor or child health nurse if:
- you have any other concerns
- your baby is not gaining weight
- there is a change in bowel movements or urination
- your baby shows signs of discomfort or pain.
Reflux and lactose intolerance - video
Video provided by Raising Children Network.
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Last reviewed: January 2021