Is my baby's reflux normal, or should I be worried?

By Dr Jonathan Dudzik

Paediatric gastroenterologist in Ashgrove, Brisbane

It’s not unusual for babies to bring up milk after feeds. In fact, reflux is one of the most common concerns raised by parents during infancy.

While it can be messy and sometimes worrying to watch, reflux is often a normal part of a baby’s development and usually improves with time.

Why is reflux so common in babies?

Reflux occurs when stomach contents flow back into the oesophagus (food pipe). In babies, this is often because the valve between the oesophagus and stomach is still developing.

As a result, milk can easily travel back up after feeds, particularly when babies are lying flat or have a full stomach.

In many cases, babies with reflux are:

• happy and settled most of the time
• feeding well
• growing appropriately
• meeting developmental milestones.

Symptoms often peak around four months of age and gradually improve as babies become more upright, start solids, and the digestive system matures.

When is reflux not just reflux?

Although reflux is usually harmless, there are times when symptoms warrant further assessment.

Parents should seek medical advice if reflux is associated with:

• poor weight gain
• feeding refusal
• significant distress during or after feeds
• persistent coughing or breathing problems
• blood in vomit
• frequent choking episodes.

These symptoms may indicate that something more than normal infant reflux is contributing to your baby’s difficulties.

Could it be something else?

Not all feeding or settling problems are caused by reflux.

Conditions such as cow’s milk protein allergy, feeding difficulties and other gastrointestinal disorders can sometimes cause symptoms that look very similar. This is one reason why obtaining the correct diagnosis is important before starting treatment.

A careful assessment of your baby’s feeding, growth and symptoms can help determine what may be causing the problem.

Do babies with reflux need medication?

Many parents are surprised to learn that reflux medication is not always necessary.

Most babies with uncomplicated reflux improve naturally as they grow. Reflux medicines are not effective for every baby and, like all medications, may have potential side effects.

For this reason, treatment should be based on an accurate diagnosis rather than symptoms alone.

Reassurance for parents

Although reflux can be stressful for families, the good news is that most babies outgrow it as their digestive system matures.

If you are concerned about your baby’s feeding, growth or comfort, speaking with your GP, paediatrician or paediatric gastroenterologist can help determine whether the symptoms are part of normal infant development or whether further assessment may be beneficial.