How to Manage Baby Reflux

What is reflux?

Reflux is very common in babies, and almost all babies will demonstrate some signs of reflux such as bringing up small amounts of milk or vomiting, during or soon after a feed. This is because the opening between a baby’s stomach and oesophagus (the lower oesophageal sphincter) is weak, and so the contents of the stomach can freely flow back into the oesophagus. It usually gets better over time, as the sphincter becomes stronger.

How do I know if my baby has reflux?

Reflux usually starts before a baby is 8 weeks old and gets better by the time they’re 1.

Symptoms of reflux in babies include:

  • bringing up milk or being sick during or shortly after feeding
  • coughing or hiccupping when feeding
  • being unsettled during feeding
  • swallowing or gulping after burping or feeding
  • crying and not settling
  • not gaining weight as they’re not keeping enough food down

Sometimes babies may have signs of reflux, but will not bring up milk or be sick. This is known as silent reflux.

How do I manage my baby’s reflux?

As long as your baby is happy, healthy and growing well, you don’t need to seek medical support for reflux, however there are some things you can do to help manage it.

  1. When you feed your baby think about your baby’s positioning, making sure their head is above their tummy.
  2. Keep your baby upright for at least 20 minutes after a feed, and let gravity do its job. This is the time to steal those cuddles! If you do need to put your baby down, try to avoid laying them down on their back, as this is when the milk can freely move through a weak sphincter.
  3. Don’t over feed your baby. If you are breastfeeding it is difficult to tell how much your baby is getting, and you should feed until baby wants to stop. When bottle feeding however, babies can drink the milk more easily and so may take larger volumes of milk, which then results in vomiting. It is important to give your baby the right amount of milk for their weight, rather than what it says on a formula label.
  4. Giving smaller and more frequent feeds can help the milk to stay down better.
  5. If formula feeding, think about how you make up a bottle of formula. Ensure you measure the milk powder accurately and follow the instructions on the packet. It is also important to avoid introducing lots of air into the milk, so avoid shaking a bottle to mix it, and try stirring the milk in with a spoon instead. Some bottle teats can let more air in than others so it may be helpful to try anti colic teats.
  6. Sometimes reflux can be a sign of cow’s milk protein allergy which would require a discussion with a GP or paediatric dietitian.

When to seek professional help for reflux

If your baby has reflux and you are concerned you should firstly discuss this with your health visitor. You should contact your GP if your baby:

  • is not improving after 2 weeks of trying the above suggestions
  • gets reflux for the first time after they are 6 months of age
  • has ongoing reflux after 12 months
  • is not gaining or is losing weight

If you are concerned about your baby’s reflux and you would like to discuss this with me, please do get in touch via my contact page.

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