Reflux in babies: Everything you need to know

Baby wrapped in towel
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Sisters Marina Fogle and Dr Chiara Hunt discuss everything you need to know about reflux in babies

All babies cry, some more than others, and some seemingly all the time. But when does excessive crying suggest that there might be a medical reason behind it?

What is reflux?

Reflux is when the muscle at the top of the stomach isn’t strong enough, allowing milk and stomach acid to travel up the oesophagus. It’s a mild occurrence for a lot of infants, causing vomiting or ‘possetting’ after a feed. For most little ones, it doesn’t cause much discomfort.

However, when it’s severe it can be painful and even lead to worrying weight loss. Sometimes milk travels all the way up, causing them to vomit often, losing most of their feed and resulting in poor weight gain.

What is silent reflux?

Silent reflux is when acidy milk goes up and down the oesophagus. This can be very difficult to diagnose, as although these babies tend to scream all the time, they won’t vomit more than normal babies.

What are the symptoms of silent reflux?

Silent reflux is often confused with colic, as the symptoms are similar. Babies with both are clearly uncomfortable, but babies with reflux tend to scream all day long, while colic tends to affect babies more in the evenings. Colic can often be eased with over-the-counter remedies such as Infacol, and babies tend to grow out of it between 10 and 12 weeks.

What is the cause of reflux?

Many paediatricians believe we see reflux more nowadays because we’re likely to put infants to sleep on their backs. ‘Refluxy’ babies are more comfortable on their fronts, yet putting babies to sleep on their backs significantly reduces the risk of cot death. So, as tempting as it might seem to let your baby to sleep on her front, don’t – it’s not safe.

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How should I treat reflux?

Most reflux can be diagnosed by a GP or a paediatrician simpy by talking to the mother and examining the baby. In severe cases, tests can confirm a diagnosis, but these are somewhat invasive so aren’t done routinely.

The treatment for both reflux and silent reflux is the same. Many cases will need only simple measures, but others require prescription medication – commonly Ranitidine or Omepraole – to reduce acid production.

It may help to keep your baby upright during and after feeds, and to pop her in a bouncing chair for naps. 

Feed little and often, particularly if she’s vomiting a lot. You can get feeding thickeners or special formula designed for babies with reflux. It is sometimes linked to cow’s milk-protein allergy, especially if your baby also has eczema, so your GP might suggest a cow’s milk-free formula. If you’re breastfeeding, try excluding dairy from your diet for at least two weeks. Early weaning may help too; paediatricians recommend weaning ‘refluxy’ babies between four and six months.

Other options include dummies, which encourage the baby to suck the acid back down, while cranial osteopathy can calm infants. Gentle pressure or a warm pad held against the tummy can also ease the discomfort of a bad spell. By coating the digestive tract, Gaviscon and sodium alginate will reduce symptoms.

As miserable as it can be for both of you, the vast majority of infants grow out of reflux within the first six months or once established on solids, even without treatment. Most ‘refluxy’ babies will go on to be robust, happy toddlers that are full of beans and ready to explore the world! 

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