Reflux or vomiting

Reflux, gastroesophageal reflux (GOR), regurgitation, or “spilling” of gastric contents in babies is when the stomach contents effortlessly enter the oesophagus or the mouth. Usually, it is swallowed, but sometimes it spills out of the mouth. Reflux is very common, with around two thirds of babies under the age of 4 months having at least one episode daily. From 4 to 8 months this decreases to one third of babies, and by 12 to 14 months of age, almost all babies no longer overtly regurgitate. For distressed parents dealing with a very unsettled infant, this may be reassuring to know.

Why does reflux occur in babies?

Babies have a shorter oesophagus than older children, and when this lengthens over time, symptoms often subside. In addition, the sphincter between the stomach and oesophagus (lower oesophageal sphincter) matures as infants grow, again reducing reflux episodes. Finally, babies spend a lot of time horizontal, hence the developmental milestone of sitting often assists to alleviate reflux.

Other signs and symptoms of GOR

Besides regurgitation, babies with GOR may exhibit:

  • Back arching
  • Abdominal pain
  • Oesophagitis
  • Excessive screaming and irritability
  • Gulping
  • Recurrent chest infections due to aspiration
  • Feed refusal
  • Inadequate weight gain

These symptoms are either due to the volume regurgitated, or the acidity of the refluxed contents.

Diagnosis of GOR

If your baby exhibits symptoms of GOR it is important to seek the advice of your health care professional.

Management of GOR

  • Small regular feeds of breastmilk or formula are better tolerated in some infants, rather than over-feeding.
  • The use of thickened feeds may assist some infants with volume-related reflux, but doesn’t typically assist acid related reflux.
  • Keeping infants upright for 30 minutes post feeds, and tilting the cot can assist to reduce symptoms.

Gastroesophageal reflux disease

Gastroesophageal reflux disease (GORD) often presents with the more troublesome and severe symptoms of GOR, and may be diagnosed when GOR does not resolve over time. It is important to seek the advice of your health care professional for diagnosis and management of GORD.

Where to get help and support for parents?

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