Infant acid reflux occurs when food backs up (refluxes) from a baby's stomach, causing the baby to spit up. Sometimes called gastroesophageal reflux (GER), the condition is rarely serious and becomes less common as a baby gets older. It's unusual for infant reflux to continue after age 18 months
Infants are more prone to acid reflux because their LES may be weak or underdeveloped. In fact, it’s estimated that more than half of all infants experience acid reflux to some degree.
The condition usually peaks at age 4 months and goes away on its own between 12 and 18 months of age.
It’s rare for an infant’s symptoms to continue past 24 months. If they persist, it may be a sign of gastroesophageal reflux disease (GERD), which is a more severe condition. While they may vary, the 10 most common signs of acid reflux or GERD in infants include:
- spitting up and vomiting
- refusal to eat and difficulty eating or swallowing
- irritability during feeding
- wet burps or hiccups
- failure to gain weight
- abnormal arching
- frequent coughing or recurrent pneumonia
- gagging or choking
- chest pain or heartburn
- disturbed sleep
Check if your 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.
Things you can try to ease reflux in babies
Your baby does not usually need to see a doctor if they have reflux, as long as they're happy, healthy and gaining weight.
Do
- ask a health visitor for advice and support
- get advice about your baby's breastfeeding position or how to bottle feed your baby
- hold your baby upright during feeding and for as long as possible after feeding
- give formula-fed babies smaller feeds more often
- make sure your baby sleeps flat on their back (they should not sleep on their side or front)
Don't
- do not change your diet if you're breastfeeding
- do not raise the head of their cot or Moses basket
Non-urgent advice:See a GP if your baby:
- is not improving after 2 weeks of trying things to ease reflux
- gets reflux for the first time after they're 6 months old
- is older than 1 and still has reflux
- is not gaining weight or is losing weight
Urgent advice:Ask for an urgent GP appointment or call 111 if your baby:
- has sick that's green or yellow, or has blood in it
- has blood in their poo
- has a swollen or tender tummy
- has a very high temperature or they feel hot or shivery
- keeps being sick and cannot keep fluid down
- has diarrhoea that lasts for over a week or has signs of dehydration
- will not stop crying and is very distressed
- is refusing to feed
If a GP thinks something else is making your baby sick, they may send your baby for tests in hospital with a specialist.
Treatment for reflux in babies
A GP or specialist may recommend some treatments for reflux.
If your baby is formula-fed, you may be given:
- a powder that's mixed with formula to thicken it
- a pre-thickened formula milk
If the thickening powder does not help or your baby is breastfed, a GP or specialist might recommend medicines that stop your baby's stomach producing as much acid.
In very rare cases, surgery might be needed to strengthen the muscles to stop food or milk travelling back up.
This is usually only after trying other things or if their reflux is severe.
Causes of reflux
Reflux happens because muscles at the base of your baby's food pipe have not fully developed, so milk can come back up easily.
Your baby's muscles will develop as they get older and they should grow out of it.