Recognising reflux


In most babies, reflux can be easy to spot – your little one spits up after a feed, and this can occur in both breastfed and bottle-fed babies. However, reflux can sometimes be trickier to identify.

This happens when your little one swallows the nasty mixture of milk curd and stomach acids,or it doesn’t travel all the way up the oesophagus (food pipe) but stays lodged uncomfortably in her diaphragm area and throat. This is known as silent reflux.

Apart from spitting up milk, other symptoms include:

  • Discomfort when feeding, such as squirming, arching the back, or turning away.
  • A chronic cough or frequent coughing during the night, sometimes combined with a runny nose.
  • “Fussiness” or crying after feeds.
  • Foul breath, “wet” burps and frequent bouts of hiccups.
  • Bad sleeping habits, and waking often at night.
  • Comfort feeding (to alleviate the pain).
  • Poor weight gain.

What causes it?

Reflux, also known by the longer (and scarier) medical term gastro-oesophageal reflux disease or GORD, occurs in about 50 percent of babies under the age of three months. By the age of 12 months, less than 10 percent of children still suffer from it.

It’s thought the main cause of reflux in infants is an immature digestive system. What happens is that the muscular valve that separates the stomach and the oesophagus is not fully developed yet,
so it allows food and milk mixed with digestive juices to escape back up the food pipe, into the throat and mouth. As your baby grows older, this valve becomes stronger and keeps the digesting
food from doing so.

In a few cases, reflux is caused by a food allergy or intolerance. That’s why it is important to consult with your doctor when reflux starts becoming an issue, so that the real cause can be identified.

What to do


Switch to a schedule of smaller, more frequent feeds as baby may be too full, and the excess milk is pushing up the oesophagus. If your baby vomits after a feed, don’t try “top up” with more milk; rather wait until the next feed.

Also, no over-vigorous winding or bouncing after eating. If your baby has not burped after five minutes, leave it be.


Hold your little one in an upright position when feeding, and after each feed, keep your baby upright for 20 to 30 minutes – giving the stomach contents a chance to settle. If it’s a day-time feed, and you need your hands free, use a baby sling. At night, elevate the head of the cot, or invest in an infant sleeping wedge or a baby hammock. For “tummy time” sessions on the floor, limit these to when baby’s stomach is not full.


If your baby is bottle-fed, discuss switching to a hypoallergenic, antire reflux or lactose-free formula with your paediatrician. Reflux symptoms are similar to those of an allergy or intolerance to cow’s milk. Breastfeeding moms might consider cutting out cow’s milk to see if it makes a difference.

Other foods that can aggravate re ux in the breastfeeding baby are citrus fruits, tomato, fatty or spicy foods, chocolate and carbonated drinks.


Make sure your clothes with elastic waistbands aren’t too tight – and the same goes for nappies. Always change nappies before a feed, taking care to keep baby’s head and shoulders elevated, and
not to lift the legs too high – rather turn them to the side.

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