Reflux in babies

Also known as spilling or spitting up

Key points about reflux in babies

  • The medical name for reflux is gastro-oesophageal reflux.
  • Reflux is when your baby's stomach contents are released back up towards their mouth.
  • It's very common and doesn't usually hurt pēpi.
  • Reflux mostly gets better by itself with time – most often by the time your baby is 1 year old.
  • Reflux doesn't usually need any investigation or treatment.
  • See your healthcare provider or Well Child nurse if you are worried.
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Reflux is when your baby's stomach contents are released back into their food canal and mouth. The food canal is called the oesophagus. It's a long tube of muscle that runs from the mouth to the stomach.

The medical name for reflux is gastro-oesophageal reflux, or 'GOR'. Reflux is very common and happens in around half of all babies and doesn't usually need any special tests or treatment.

Reflux mostly gets better by itself with time.

Milk in the stomach is more likely to be released back up towards a baby's mouth because:

  • the muscles (sphincter) between a baby's stomach and oesophagus are less well developed
  • young babies only drink milk – it's easier for milk to come back up than solid food
  • babies spend more time lying down.

Babies often bring up milk during or shortly after feeding. This is sometimes called spilling or reflux and is different to vomiting. Reflux is effortless, vomiting is forceful.

  • You might hear your baby burp, belch or swallow hard.
  • Most reflux is swallowed back into the stomach but sometimes it comes all the way back up into your baby's mouth.
  • Parents are usually more aware of the reflux when the milk comes all the way up to the mouth, especially after feeds.
  • It doesn't usually harm your baby and is unlikely to cause problems later on in life.

Although it can be very distressing to parents, babies do reflux and bring up feeds more than older children, and it usually gets better by itself.

  • Reflux usually begins before babies are 8 weeks old and may get worse until they are around 4 months of age.
  • Most babies get better before they're a year old. This probably happens because babies are spending more time sitting and standing by this age. They're also eating more solid foods.
  • A small number of babies continue to have symptoms after the toddler period.

Reflux can be upsetting for parents. It's natural to be worried that something is wrong.

There are a number of simple steps you can take which may help your baby:

  • take your time with feeds and try to stay calm and relaxed
  • burp your baby regularly throughout feeding
  • don't force them to take more milk than they want – some babies like to feed small amounts often
  • if you're bottle feeding, check that the hole in your baby's teat is not too big – giving milk too quickly can make reflux worse
  • hold your baby upright for a short time after feeding.

Remember, if your baby brings up a lot of milk, they may be hungry again quite quickly. If that happens, you might need to feed them again sooner than usual.

Is there anything else I should do about reflux?

For most babies, you don't have to do anything about reflux. It's a natural process which will get better by itself.

Changing formulas won't help the reflux and neither will changing from breastfeeding to bottle feeding.

See your healthcare provider or Well Child nurse if:

  • you're worried
  • the reflux becomes forceful (takes effort)
  • the reflux is green or dark yellow
  • you see blood in the reflux
  • there are any changes in your baby you're not sure about
  • the reflux carries on after your baby turns 1.

Reflux won't normally cause other problems.

In a very small number of babies, reflux can lead to problems. In this case, your baby might have gastro-oesophageal reflux disease (GORD).

A baby with GORD may have:

  • long or frequent periods of irritability and crying
  • blood visible in the reflux
  • back arching after feeds
  • poor sleeping
  • poor weight gain
  • a long-lasting cough or wheezy breathing.

If you're worried about any of these signs please contact your healthcare provider. They will discuss with you whether your baby needs any tests or treatments.

Note: Most crying babies don't have reflux.

Guidelines and clinical resources

Gastro-oesphageal reflux(external link) Starship Chlidren's Health Clinical Guideline, NZ
Irritable infants reflux and GORD(external link) BPAC, NZ, 2011
Gastro-oesophageal reflux disease(external link) NZ Formulary for Children
Crying babies: Can proton pump inhibitors help?(external link) Tools for Practice, 2023

Continuing professional development

Infant Gastroesophageal Reflux Disease and Cow's Milk Protein Allergy, with Dr Ania Hargrove, Paediatrician

(external link)
(The GP Show, 2019)

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Credits: Content shared between HealthInfo Canterbury, KidsHealth and Health Navigator NZ as part of a National Health Content Hub Collaborative.

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