Reflux in babies: when bringing up milk is normal
Why so many babies bring up milk after feeds, what helps, what to avoid and when to see the paediatrician.
4 min read
In this article
Most babies bring up a little milk during or after feeds. This is called reflux, and it happens because the muscle at the bottom of the food pipe, which keeps milk in the stomach, is still weak. It usually starts before 8 weeks and gets better by itself by the age of 1, as the muscle gets stronger.
If your baby is content, feeding well and gaining weight, reflux is not an illness and does not need medicine. A damp sheet after every feed is a nuisance, not a danger.
What it looks like
- bringing up milk or being sick during or shortly after feeds
- coughing or hiccups while feeding
- being unsettled during feeds
- swallowing or gulping after burping or feeding
- crying and not settling
Sometimes babies have these signs without bringing up milk. This is called silent reflux.
What helps
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1
Keep them upright
During feeds and for as long as you can afterwards, hold your baby upright.
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2
Burp during feeds
Burp your baby several times during the feed, not just at the end.
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3
Check how they feed
If you breastfeed, ask for help with positioning and attachment. If you bottle feed, check the amount and the size of the teat hole.
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4
Sleep on the back, on a flat surface
Always put your baby to sleep on their back, even with reflux. Do not raise the head of the cot or put a pillow underneath.
What not to do
- Do not put them to sleep on their tummy or side “so they do not choke”. A healthy baby sleeping on their back protects their own airway. Tummy sleeping raises the risk of sudden infant death. Read safe sleep for babies.
- Do not give tea, sugared water or chamomile to a baby under 6 months to settle their stomach. It takes the place of milk and does not cure reflux.
- Do not keep switching formula without talking to the paediatrician. It often does not help and makes the cause harder to find.
- Do not give antacids without a prescription.
When to see the paediatrician
Make an appointment if your baby:
- is not improving after trying the steps above
- gets reflux for the first time after 6 months
- is over 1 and still has reflux
- is not gaining weight or is losing weight
The paediatrician may check for cows’ milk protein allergy, which can look like reflux. For formula-fed babies they may suggest a thickened formula. Medicines are only used when these do not help.
Get urgent help
See a doctor straight away or call 127 if your baby:
- vomits green or yellow fluid, or blood
- vomits forcefully, in an arc
- has blood in their poo
- has a swollen tummy or one that hurts when you touch it
- has a high temperature, or is shivery
- keeps vomiting and cannot keep fluids down, or shows signs of dehydration. See diarrhoea and vomiting in babies
- refuses feeds, or cries non-stop and is very distressed
Common questions
How much milk can my baby bring up before I should worry?
Should my baby sleep slightly raised?
When does reflux stop?
Sources we consulted
- NHS: Reflux in babies
Written by the mam.al editors as general information. It does not replace advice from your paediatrician. Contains public sector information licensed under the Open Government Licence v3.0.