Reflux

Reflux happens when some of the partly digested milk or food in the stomach comes back up the tube from the mouth to the stomach (oesophagus). It can sometimes reach the baby’s throat and mouth.

The stomach contains acid that helps to digest food. The acidity of the food coming back up to the throat can cause some discomfort and burning sensations. This can be painful for babies and they may become irritable during and after feeding.

Why does reflux happen?

Reflux happens when the band of muscle between the food pipe and the stomach opening is weak and cannot close properly. This band usually opens when food is about to enter the stomach and closes so that food stays in the stomach.

Babies born premature or sick are more likely to experience reflux, but it is very common and affects nearly half of all babies in some way.

Signs of reflux in babies can include the following:

• Bringing milk back up during or after feeds.
• Vomiting that often shows no clear pattern in terms of timing or amount.
• Persistent hiccups and coughing.
• Fussiness, crying and restlessness.
• Refusing feeds or only taking small amounts of food.
• Choking or gagging.

If untreated, more severe complications of reflux can include the following:

• Frequent chest infections.
• Poor weight gain.
• Difficulties with feeding, including a reluctance to feed.

Mild reflux usually improves on its own and gets better when your baby begins to wean onto solids. Treatment depends on the severity of the reflux. But there are ways you can help too. Here are some ways you can help your baby:

• Give your baby skin-to-skin after a feed, to allow the food to settle.
• For some babies it is helpful for them to be fed in different positions. You could try to feed your baby in a more upright position. Speak to staff on the neonatal unit if you have questions or need support with positioning your baby for feeding.
• Keep your baby’s head gently raised during the day, especially after a feed. Reflux is worse when a baby is lying flat on their back. Do not put anything directly under your baby’s head, and never use a pillow with a baby under 12 months old.
• Change your baby’s nappy before feeding.
• Feed your baby with smaller amounts of milk more often.
• Wind your baby more frequently. To wind, rub rather than tap your baby.

Your GP may also give you some medications to help. These may include feed thickeners, which are added to your baby’s milk to help reduce the effect of reflux. Thickeners work by making the food more solid once it is in the stomach and this makes it harder to bring back up.

Other medications may help to stop your baby’s stomach producing too much acid and speed up food passing through the stomach. Feed thickeners should only be used if they have been prescribed by a medical professional such as a GP.

Reflux usually gets better on its own, as babies’ muscles develop. If treatments and medications do not help, then your baby may need to be referred to a specialist. They will be able to tell you if your baby needs any further tests.