Is my baby’s reflux normal, or is something wrong?

Key points

• Reflux is common for babies, and usually causes no problems
• Sometimes reflux causes complications which require medical help
• See your doctor if you are concerned – don’t self-diagnose

A burning sensation in the chest and a yucky sour taste in your mouth … reflux isn’t pleasant for anyone. For babies, reflux is common. Essentially it means food from their stomach is coming back up the food tube and into their mouth. Most of the time it’ll be swallowed back into the stomach, but sometimes a baby will regurgitate it (sometimes doctors call this posseting).

Reflux usually causes no problems and most babies grow out of it. However sometimes reflux is a sign your baby might need medical attention. We sought the help of Dr Preeya Alexander as a GP and health expert to help you understand what’s going on.

“We have a pipe called the oesophagus that takes milk – and food, in the case of adults –from the mouth to the stomach,” she explains. “There is a sphincter which sits between the oesophagus and the stomach to try and prevent the contents of the stomach from coming back up into the oesophagus. Reflux is when you can get the stomach contents coming back up into the oesophagus and it is very normal in young infants because the sphincter is immature and not yet as strong as it should be.”

You can find out more about the signs of reflux, and get advice on how to manage it, here.

What is normal reflux?

So how can you tell whether your baby’s reflux is normal or problematic?

Dr Preeya says normal reflux is known as gastro-oesophageal reflux.

“The stomach contents pass into the oesophagus, and you might notice your infant has some effortless vomits or possets,” she explains. “It is common and it resolves on its own as the sphincter develops and matures.

”A good indication that your baby falls into this ‘normal’ category would be that they’re otherwise healthy.“

The infant in this case is growing well and thriving, and the condition does not tend to cause infants to cry excessively or be irritable,” Dr Preeya says. “The child has some effortless vomits now and then.”

Dr Preeya says this type of reflux doesn’t require medical intervention.

“As the sphincter strengthens the issue tends to resolve,” she says, adding: “We can suggest some simple supportive measures like holding the infant upright for 30 minutes after a feed which can help.”

What about abnormal reflux?

Reflux becomes problematic when it causes complications – which is known as gastro-oesophageal reflux disease (often referred to as GORD). GORD can involve vomiting, fussiness, distress, problems gaining weight and choking, coughing or wheezing during feeds – find out more here.

“GORD is a different entity to gastro oesophageal reflux alone and tends to have serious flow-on effects,” says Dr Preeya.

A 2018 medical review found that the best way to manage GORD is by getting education and reassurance from a healthcare professional as well as guidance on nutritional solutions, with medication being a last resort.

When should I see a doctor?

If you think your baby might have GORD, it’s important to get medical advice.

“Parents should run this by someone like their GP, maternal child health nurse or paediatrician if they are concerned,” says Dr Preeya. “Nothing like this should be self-diagnosed because it can lead to treatments or interventions that are not required.

“If you think your child has reflux, we will take a full history and nut out what is happening with feeds, if there is vomiting, etc, and perform an examination including an abdominal examination and a check on growth.”

Reflux can also be a sign of cow’s milk allergy – learn more about the condition here.

REMEMBER: This article is not to be substituted for medical advice. If you’re concerned about your baby crying excessively, or have questions about reflux, cow’s milk allergy, GORD or any other conditions, please speak to a healthcare professional such as a pharmacist, GP or maternal child health nurse.

Disclaimer:
 Dr Preeya Alexander is an independent expert who was compensated for her time.

References

https://www.nhs.uk/conditions/heartburn-and-acid-reflux/

https://www.betterhealth.vic.gov.au/conditions-and-treatments/infant-reflux

https://www.rch.org.au/kidsinfo/fact_sheets/Reflux_GOR_and_GORD/

https://nutricia.co.nz/aptamil/parents-corner/nutrition-essentials/how-to-help-baby-with-reflux/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120453/