Reflux factsheet
Introduction
Reflux, also called gastro-oesophageal reflux (GOR), is when food and acid from the stomach come back up into the oesophagus or mouth after eating.
The oesophagus is the tube from the mouth to the stomach. A valve at the top of the stomach usually stops food and acid from coming back up. Reflux happens when the valve opens again. This can happen due to weak or undeveloped muscles, or pressure and pushing from the stomach.
In babies, reflux is often called posseting. It is common and usually happens after feeding.
Reflux normally improves by 12 to 18 months of age. It may last longer if your child:
- has a condition affecting their muscles, like cerebral palsy
- takes certain medicines
- is exposed to cigarette smoke
- is above a healthy weight range for their age.
Ongoing reflux that causes complications is called gastro-oesophageal reflux disease (GORD).
Signs and symptoms
Most babies and children with reflux grow and develop normally, even if they bring up milk or formula often. It may feel unpleasant, but it shouldn’t cause distress.
Babies with GORD may also:
- seem irritable or unsettled, especially after feeds
- find it hard to settle to sleep
- arch their back
- have poor weight gain
- choke, gag, or cough during feeds.
See a doctor as soon as possible if your child:
- has blood-stained vomit that looks like dark coffee grounds
- suddenly loses weight
- has black or tar-like poo
- has blood or mucus in their poo
- refuses to eat
- has a swollen, painful tummy
- has a fever
- still regurgitates after 18 months
- vomits yellow or green fluid.
If vomit looks yellow to dark green, call triple zero (000) for an ambulance or go to your nearest emergency department.
This is called bilious vomiting and may be a sign of a serious, life-threatening bowel problem.
Diagnosis
Your local doctor or child and family health nurse can usually diagnose reflux by:
- asking about your child’s feeding and health
- watching them feed.
If reflux is the only symptom and your child is healthy, tests are not needed.
If your child’s doctor is concerned about GORD or other complications, they may order tests like:
- a barium swallow x-ray - your child drinks a special liquid to help show swallowing on an x-ray
- an oesophageal pH or impedance study - a small tube through the nose measures reflux over 24 hours
- an endoscopy - a thin camera is used to check the oesophagus for damage.
Treatment
Most reflux doesn’t need treatment and gets better over time. Reflux and GORD can still be upsetting for parents and babies, as they may affect feeding, sleeping, and crying patterns.
If you're finding it hard to manage, talk to your doctor or child and family health nurse for support and safe tips.
You can also try:
- following safe sleep recommendations - putting your baby on their back to sleep, on a firm, flat mattress
- keeping your baby comfortably upright during feeds
- letting your baby rest upright after feeding and avoiding bouncing or playing straight away
- not smoking or vaping near your baby or in spaces they spend time, like the car or house.
If your child has more severe GORD, their doctor may suggest medicine or changes to their diet.
Management
Colic
Colic is a word to describe a stage where babies cry for long periods without a clear reason.
Crying can last over three hours at a time, becoming worse in the late afternoon or evening.
It usually starts between 2 and 16 weeks of age and affects around one in three babies.
Babies with colic may be hard to soothe with cuddles or rocking, but are otherwise:
- healthy
- gaining weight
- not showing signs of other problems like reflux.
There is no test for colic. Your local doctor will check for other possible causes before diagnosing it.
Coping with reflux and colic
Caring for a baby with reflux or colic can be stressful.
It’s okay to place your baby in a safe space, like a cot, and step away for a short break if you feel overwhelmed.
Some parents find that noise-reducing earplugs help lower stress while still letting them hear and respond to their baby.
Remember that you are not alone. If you are finding it hard to manage, speak to your doctor or child and family health nurse about support and safe strategies.
Resources and more information
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Tresillian Parent’s Help Line
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Karitane Careline
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PANDA National Helpline
