Reflux factsheet

Introduction

Reflux is also known as gastro-oesophageal reflux, or GOR. It is when the contents of the stomach are brought back up into the oesophagus or the mouth after eating.

The oesophagus is a tube that leads from the mouth to the stomach with a valve that stops food and stomach acid from coming back up. Reflux is when the valve at the top of the stomach opens back up, allowing stomach acid and contents to travel upwards. This can be caused by muscle weakness or underdevelopment, and increased pressure or pushing from the stomach.

In babies, reflux is often called posseting. Posseting is common and happens after feeding with the breast or bottle.

Reflux should usually stop by about 12 – 18 months of age, unless there are other health issues including:

  • conditions that affect the muscles, like cerebral palsy
  • taking certain medications
  • exposure to cigarette smoke
  • obesity.

Some children can develop complications from ongoing reflux. This is called gastro-oesophageal reflux disease (GORD).

 Signs and symptoms

Most babies and children with reflux should gain weight and develop normally, even if it seems like they bring their milk or formula up quite often. Reflux may feel unpleasant but should not cause any distress.

Babies with GORD can bring their milk or formula up often while also having symptoms like:

  • irritable and unsettled behaviour, especially after feeds
  • difficulty settling to sleep
  • arching of the back
  • poor weight gain
  • choking, gagging, or coughing during feeds.

See your local doctor as soon as possible if your child develops the following symptoms:

  • vomit stained with blood that looks dark, like coffee grounds
  • sudden weight loss
  • black, tar like poo
  • blood or mucus in poo
  • refusing to eat
  • bloated or swollen stomach with pain
  • fever
  • persistent regurgitation after 18 months of age
  • vomit that is a yellow or green colour.

If your child’s vomit is a colour ranging from yellow to dark green, call triple zero (000) for an ambulance or go to your nearest emergency department. This is called bilious vomiting and can be a sign of an emergency bowel obstruction.

Diagnosis

Your child’s doctor or maternal child and family health nurse can generally tell if they have reflux from their health history, watching a feed and by doing an examination. If regurgitation or posseting is the only symptom of reflux and your child is otherwise healthy, further tests are not necessary.

If your doctor or nurse thinks your child might be having complications from reflux, they may order special tests including:

  • a barium swallow x-ray - where your child drinks a special liquid that helps show swallowing on an image
  • oesophageal pH or impedance study – where a small tube is inserted into the stomach through the nose to measure the amount of reflux that happens over 24 hours
  • endoscopy – where a thin camera is inserted down the oesophagus to check for any damage caused by reflux.

Treatment

Reflux does not usually require any treatment. In most cases, it will resolve by itself in time. Reflux and GORD can be distressing for parents and babies as it can cause disruption to normal feeding, sleeping, and crying patterns. You and your baby are struggling with managing reflux, speak to your local doctor, or maternal child and family health nurse for advice and safe strategies.

Things you can try at home include:

  • following safe sleep recommendations of placing baby on their back to sleep, on a firm, flat mattress
  • keeping baby as comfortably upright as you can during breast and bottle feeding
  • giving baby time to rest after a feed by keeping them upright and reducing movement and stimulation, like bouncing or playing
  • not smoking around your child, or in areas that your child will be like the car or house.

Depending on how severe your child’s GORD is, or any other complications, their doctor may prescribe medication or recommend a change in their diet.

 Management

Colic

Colic is the word used to describe a period that babies go through where they cry in long bouts throughout the day, with no explanation. Periods of crying can last over 3 hours and will typically happen in the afternoon or evening. These periods of crying are usually resistant to soothing methods like cuddling and rocking.

Colic usually happens between 2 and 16 weeks of age and affects around 1 in every 3 babies.

Babies with colic are usually otherwise healthy, thriving, gaining weight and do not have symptoms of other illnesses, including reflux and GORD. There is no test for colic, other than ruling out any other causes.

Colic is very stressful for parents and babies. If you are struggling, speak to your local doctor, or maternal child and family health nurse for advice and safe strategies.

Coping with reflux and colic

Parents and carers should know that if they are struggling to cope with reflux, crying or colic, it is ok to put their baby down in a safe space and leave the room. This can be helpful to regulate your emotions and find some calm in a stressful situation. Some parents may also find that noise reducing earplugs can help with reducing stress and overwhelm, while still being able to respond to their crying baby.

Resources and more information

Tresillian - It's in our nature to nuture

title
Tresillian Parent’s Help Line

Phone1300 272 736
Biography
Tresillian is a non-for-profit organisation that assists parents gain confidence in their new roles as mums and dads and teach new parents about routines in breastfeeding, sleep, settling and nutrition.
Related Links
Karitane

title
Karitane Careline

Phone1300 227 464
Biography
Provides contact with a friendly and experienced child and family health nurse will support you with guidance and encouragement on your parenting journey.
Related Links
PANDA

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PANDA National Helpline

Phone1300 726 306
Biography
PANDA – Perinatal Anxiety & Depression Australia – supports the mental health of parents and families during pregnancy and in their first year of parenthood.
Related Links
Gidget Foundation Australia

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Gidget Foundation Australia

Phone1300 851 758
Biography
Gidget Foundation Australia is a not-for-profit organisation that exists to support the emotional wellbeing of expectant and new parents to ensure they receive timely, appropriate and specialist care.
Related Links

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.

© Sydney Children’s Hospitals Network 2024


This factsheet was produced with support from John Hunter Children's Hospital.