Signs of Reflux in Babies: Symptoms, Causes, and When to Worry

Welcoming a new baby is exciting, but it can also bring questions and worries especially when feeding doesn’t seem to go smoothly. One of the most common concerns for parents is signs of reflux in babies. Spitting up, unsettled feeds, and frequent crying can leave you wondering whether it’s normal or something more serious.

In most cases, reflux is a natural process linked to an immature digestive system. However, understanding the difference between typical babies reflux and more persistent reflux disease can help you feel confident about when to simply monitor things and when to seek support.

This introductory guide explains symptoms of reflux, causes, feeding tips, and when medical advice may be needed all in clear, practical language.

What Is Reflux in Babies?

Reflux in babies happens when milk travelling back up from the baby's stomach into the food pipe (oesophagus) causes milk to spill out or be swallowed again. This is known as gastro oesophageal reflux.

The reason this happens is simple:

• The lower esophageal sphincter (a small muscle that stops food returning upwards) is still developing.
• A baby’s stomach is small and fills quickly.
• Babies spend a lot of time lying flat.
• Feeding swallowing patterns are still maturing.

Because of this, many babies spit small amounts after feeding. Most reflux is harmless and improves naturally over time.

How Common Is Babies Reflux?

Reflux is extremely common. Many babies spit regularly in the first few months of life. It typically peaks around 3–4 months old and gradually settles as babies begin sitting upright and eating solids.

Healthy babies who are gaining weight and otherwise content usually do not need medical treatment.

Main Signs and Symptoms of Reflux

Parents often ask: How do I tell if my baby has reflux?

Here are the common signs and symptoms:

1. Frequent Spitting Up

Babies spit small amounts after feeds. Baby brings milk back up, especially when burping or lying down.

2. Feeding Crying

Some babies cry during or after feeding. This may be due to discomfort as stomach contents move upward.

3. Feeding Coughing

Milk coming back up can trigger feeding coughing or gagging.

4. Arching the Back

Babies may stiffen or arch if uncomfortable.

5. Swallowing Without Spitting

In silent reflux, baby swallows milk that comes up without visible spit-up.

6. Swollen or Tender Tummy

Occasionally a baby’s stomach may feel bloated, though this is less common.

7. Reflux Worse When Lying Flat

Symptoms often appear more noticeable when baby sleeps flat.

What Is Silent Reflux in Infants?

Silent reflux refers to gastroesophageal reflux where milk returns up the food pipe but is swallowed again instead of being spat out.

Symptoms may include:

• Persistent unsettled behaviour
• Feeding difficulty
• Frequent swallowing
• Hoarse-sounding cry
• Poor sleep

Because there is no visible spit-up, silent reflux can be harder to identify.

When Reflux Becomes Gastro Oesophageal Reflux Disease

Most reflux is mild. However, sometimes it progresses to gastro oesophageal reflux disease (GORD reflux).

Gastroesophageal reflux disease is suspected when reflux symptoms affect baby’s growth or comfort significantly.

Warning signs may include:

• Poor weight gain
• Losing weight
• Projectile vomiting
• Persistent feeding crying
• Blood in vomit
• Difficulty feeding
• High temperature
• Signs of dehydration

If symptoms continue over a week without improvement, or worsen, seek advice from a GP or healthcare professional.

What Causes Reflux in Babies?

Reflux is usually caused by immaturity of the digestive system. However, several contributing factors may include:

1. Immature Lower Esophageal Sphincter

This muscle stops food from travelling back up.

2. Lying Flat

Baby sleeps flat for much of the day, increasing reflux.

3. Overfeeding

A very full stomach increases pressure.

4. Cow’s Milk Protein Sensitivity

Some babies may react to cow’s milk protein found in standard baby’s formula or through dairy products in breastfeeding parent’s diet.

5. Swallowing Air

Feeding swallowing too quickly may increase pressure in baby’s stomach.

In rare cases, digestive and kidney diseases may need investigation, particularly if symptoms are severe or persistent.

Breastfed Babies vs Formula Fed Babies

Both breastfed babies and formula fed babies can experience reflux.

Breast milk is often digested more quickly, which may reduce symptoms for some infants.

Formula fed babies may experience reflux related to:

• Milk protein sensitivity
• Larger feed volumes
• Slower digestion

If concerned about baby’s formula, speak with your GP before making changes.

How Do I Tell If My Baby Has Reflux or Something Else?

It can be difficult to differentiate reflux from other conditions.

Consult a GP if you notice:

• Persistent poor weight gain
• Baby regularly refusing feeds
• Signs of dehydration
• Excessive irritability
• Green or yellow vomit
• Projectile vomiting

These may require urgent GP appointment or assessment at the nearest healthcare facility.

Cow’s Milk Allergy and Reflux

Cow’s milk allergy and reflux symptoms can overlap.

Signs that may suggest milk protein sensitivity include:

• Skin rashes
• Blood or mucus in stool
• Persistent tummy pain
• Severe feeding crying
• Poor weight gain

If suspected, your doctor may review medical history and consider dietary adjustments.

How Can I Help My Baby With Reflux?

Many babies improve with simple adjustments.

1. Keep Baby Upright After Feeding

Hold baby upright for 20–30 minutes after feeds.

2. Smaller, More Frequent Feeds

Avoid overfilling baby’s stomach.

3. Burp Gently

Frequent burping reduces trapped air.

4. Avoid Tight Clothing

Pressure on the tummy can worsen reflux.

5. Ensure Safe Sleep

Always place baby on their back for sleep, even with reflux.

6. Check Feeding Technique

Ensure proper latch for breastfeeding and appropriate teat flow for bottle feeding.

Does a Dummy Help With Silent Reflux?

Some parents find that a dummy may help soothe babies with silent reflux. Sucking can encourage baby swallows, potentially clearing small amounts of milk in the food pipe.

However, every baby is different. If unsure, speak with a healthcare professional.

When to Seek Medical Advice

Seek medical attention if your baby has:

• Projectile vomiting
• Persistent high temperature
• Refusal to feed
• Signs of dehydration
• Severe distress
• Poor weight gain or is losing weight

In urgent situations, attend the nearest emergency department.

Will My Baby Outgrow Reflux?

The reassuring news is that most babies outgrow reflux naturally.

As babies:

• Sit upright
• Begin solid foods
• Develop stronger lower esophageal sphincter muscles

Reflux usually improves significantly by 12–18 months of age.

Medical Treatment Options

If symptoms are severe, a GP may:

• Review feeding patterns
• Assess baby’s growth
• Consider thickened feeds
• Recommend medicines in selected cases

Medicines aim to reduce as much acid exposure as possible in baby’s esophagus, easing discomfort.

Medicines are usually recommended only if symptoms significantly affect baby’s growth or wellbeing.

Can Reflux Affect Baby’s Growth?

In mild cases, babies reflux does not impact gaining weight.

However, ongoing discomfort and difficulty feeding may affect baby’s growth. Monitoring weight and length during routine checks is important.

The Emotional Impact on Parents

Caring for a baby with reflux can be exhausting. Feeding crying episodes and disrupted sleep may leave parents feeling overwhelmed.

Support from a healthcare professional or GP can provide reassurance and practical advice.

Remember: reflux is common, and many babies grow out of it with time.

Frequently Asked Questions

How do I tell if my baby has reflux?

Look for frequent spit-up, feeding crying, coughing, and arching. If baby is otherwise thriving, it’s likely mild reflux.

What is silent reflux in infants?

Milk travels up but is swallowed again, causing discomfort without visible spit-up.

Does a dummy help with silent reflux?

It may soothe some babies, but effectiveness varies.

How can I ease reflux naturally?

Keep baby upright after feeds, offer smaller feeds, burp regularly, and maintain safe sleep practices.

When should I worry?

Seek medical advice for projectile vomiting, high temperature, loss of weight, persistent poor weight gain, or severe distress.

Key Takeaways

• Reflux in babies is very common.
• Most reflux is a natural process due to an immature digestive system.
• Mild symptoms usually improve with time.
• Persistent symptoms affecting baby’s growth requires medical review.
• Simple feeding adjustments often ease reflux.

Understanding the difference between normal babies reflux and reflux disease helps reduce anxiety and ensures timely care when needed.

Disclaimer

This article is for general informational purposes only and does not replace professional medical advice. Always consult your GP, health visitor, or qualified healthcare professional regarding concerns about your baby’s symptoms, feeding, growth, or overall wellbeing. If your baby shows urgent warning signs such as difficulty breathing, persistent projectile vomiting, or signs of dehydration, seek immediate medical attention.