Understanding infant reflux: causes, symptoms, and management

Infant reflux, or gastroesophageal reflux (GER), is a common condition where a baby’s stomach contents flow back into the oesophagus, causing them to spit up. While this condition can be concerning for new parents, it is usually not serious and often resolves on its own as the baby grows. Here to explain more is revered consultant paediatric gastroenterologist, Dr Benjamin Hope. 

Causes and risk factors

Infant reflux occurs because the lower esophageal sphincter (LES), the muscle that keeps stomach contents from flowing back, is not fully developed in babies. This muscle strengthens with age, which is why most infants outgrow reflux by their first birthday.

Factors that may contribute to reflux include the baby’s diet, their position during feeding, and the amount of food they consume. Overfeeding, swallowing air while feeding, or lying flat immediately after a meal can increase the likelihood of reflux.

Symptoms of infant reflux

The most obvious symptom of reflux is frequent spitting up, but other signs include irritability during or after feeding, arching the back, coughing, or gagging. In some cases, babies may refuse to eat or may not gain weight as expected. Severe or persistent reflux, known as gastroesophageal reflux disease (GERD), can lead to more serious symptoms such as poor growth or respiratory problems.

Managing infant reflux

For most infants, reflux can be managed with simple lifestyle changes. Feeding the baby smaller amounts more frequently, holding the baby upright for at least 30 minutes after feeding, and ensuring proper burping can help reduce reflux episodes. Some parents find that thickening the baby’s milk or formula with a small amount of rice cereal, as recommended by a paediatrician, can also help.

In cases where lifestyle changes do not alleviate symptoms, a paediatrician may recommend medication to reduce stomach acid or improve the function of the LES. However, these medications are typically reserved for more severe cases of GERD.