Reflux & Regurgitation 

Seeing your baby bring up milk during or shortly after feeding can be upsetting when not expected. Reflux refers to the bringing up of stomach contents into the food pipe. Regurgitation is when the stomach contents are expelled from the mouth and is also known as ‘spitting up’ or ‘posseting’.

The good news is that it is not usually a cause for serious concern, especially if your baby is putting on weight normally and seems otherwise well.

Regurgitation is a normal physiological process that can occur in otherwise healthy babies from three weeks to twelve months of age. Regurgitation must occur more than two times per day for over three weeks to be diagnosed as reflux without the presence of other symptoms.

Generally, reflux reaches its peak around four months of age and begins to resolve by seven months. In some cases, reflux symptoms may continue up to twelve months of age. Every baby will vary on this. Reflux and regurgitation in babies is perfectly normal, but there are things you can do to try and help relieve symptoms.

• Recurrent regurgitation with/without vomiting
• Constant or sudden crying
• Irritability or pain
• Waking up frequently
• An arched back during and after feeding
• Regular coughing

For breastfed and bottlefed babies:

• Make sure your baby’s clothing or nappy are not too tight around their tummy
• If breastfeeding, get additional support from a trained healthcare professional on alternative feeding positions to position your infant in a more upright position
• While feeding, try to position your baby in an upright position and keep them in an upright position for 30 minutes after a feed

For breastfed babies:

• If you find your baby is gulping, get additional support from a trained healthcare professional on alternative feeding positions to slow the flow of your milk

For bottlefed babies:

• Get advice on the appropriate volumes for your baby’s size and weight from your healthcare professional, GP or Public Health Nurse
• Offer smaller, more frequent feeds. The same total amount for 24 hours is given to your infant and is spread out so that they feed little and often
• Check that the teat size on the bottle is not too big, as this can cause babies to gulp their feed too quickly. If using a thickened feed, it is recommended to use a single hole fast flow teat

For breastfed and bottlefed babies:

• Winding is an important part of feeding your baby, as they need help to bring up trapped wind
• Make sure your baby is winded before, during, and after feeds
• The most common position for winding is to place your baby over your shoulder while supporting their bottom with an arm. Use the other arm to rub or pat their back
• Another position, usually recommended by healthcare professionals, is to sit your baby on your lap in an upright position. Support your baby’s chin with one hand and rub or gently pat your baby’s back with the other

For breastfed babies:

• Speak to your healthcare professional for more information and advice on different breastfeeding positions or possibly a suitable thickener for use with expressed breastmilk or given as a spoon feed to help thicken the contents of the stomach for the dietary management of reflux

 For bottlefed babies:

• Your healthcare professional may advise you to try a thickened formula for reflux and regurgitation
• If so, please note that some formulas will require a fast flow teat and some have slightly different guidelines on making up the feeds. All products will give guidance on this or ask your healthcare professional for further information
• Some formulas will thicken slightly in the bottle and then further thicken in the stomach so the milk feed is less likely to come back up into the mouth
• If your healthcare professional suggests a change of formula, be patient as it can take up to two weeks to see improvements - this is known as the settling period
• If you are considering using a specialist milk for the dietary management of reflux and regurgitation, speak to your healthcare professional first for more information