I Think My Baby’s Got Reflux

Reflux in babies is common, but it can be worrying when your baby brings up milk frequently or seems uncomfortable after feeds. This article explains what infant reflux is, what’s normal, and when symptoms may need further attention. It explores simple ways to reduce discomfort, including feeding and positioning, and outlines when medical treatment might be considered. It also briefly looks at cow’s milk allergy, which is sometimes suggested as a cause of reflux, but is uncommon in exclusively breastfed babies.

Summary

• Reflux is common and usually improves with time.
• Most babies don’t need treatment.
• Small changes to feeding and positioning can help.
• Cow’s milk allergy is often suggested, but rarely the cause in breastfed babies.
• Help is available if symptoms are severe or distressing.

On this page

In the early weeks, it is common for a baby to “spit up” and around half of all newborns do, at least once a day.  As a baby’s digestive system matures, this usually decreases and for most families it is just a short-term inconvenience.

In young babies, the valve between the oesophagus and stomach is still developing and opens more easily than it will later on. This allows milk to come back up into the oesophagus.

The severity of reflux is not measured by how much a baby vomits. Some babies vomit what looks like a large amount of milk, many times a day, but are healthy and happy. ¹ Reflux is not always noticeable and does not always cause discomfort. However,  symptoms are severe, it can be very painful, and distressing for both the baby, and those caring for them. Reflux that causes severe symptoms is sometimes called GORD (gastro-oesophageal reflux disease). ^{2 3}

What are the signs to look out for?

• Your baby may gag and cough, or sound hoarse.
• Some babies have bad breath.
• You might notice back-arching and head-turning. Your baby might stretch out flat to reduce pain, instead of snuggling close to you
• Your baby might cry for long periods and be irritable during and after feeds. Some babies wirth reflux are diagnosed as having ‘colic‘ (unexplained prolonged crying).
• Your baby may seem to fight feeding, or even refuse to feed. If this happens, they may gain weight slowly.

What might help?

Some simple adjustments can help reduce discomfort from reflux. You may need to experiment to find what works best for your baby and feels manageable for you.

Keeping your baby’s head higher than their bottom can be helpful. The opening from the stomach to the oesophagus is usually on the right side, so keeping your baby’s right side slightly higher than their left may also reduce symptoms.

• Holding your baby at an angle, with their bottom in your lap and their torso supported on your crossed leg, may help them feed more comfortably.

• If feeding lying down, some babies are more comfortable on their left side. When changing sides, you could try sliding your baby across rather than turning them over. Moving them to a more upright position after feeds may also help.

• Many babies with reflux are uncomfortable lying flat. They may cry or spit up when placed in a cot or crib. Holding your baby upright, or using a sling or soft carrier, can be helpful. Some parents choose to keep their baby upright for a while after feeds before laying them down. A bouncy seat that holds the baby in a semi-upright position may be helpful at times when they can’t be in-arms.

• When changing nappies, lying your baby on their left side may be more comfortable than lifting their legs, which can put pressure on the stomach.

• Some babies find car seats uncomfortable because of the pressure on their stomach. If this is the case, you might choose to limit car journeys for a time and use alternatives, such as carrying your baby in a sling.

Short, frequent feeds can often help reduce reflux symptoms. If you have a very abundant milk supply, offering one breast per feed may help – see what works best for you and your baby.

Symptoms such as reflux are frequently attributed to cow’s milk allergy, despite its rarity in exclusively breastfed babies. Overdiagnosis is increasingly recognised, along with concerns about conflicts of interest and industry influence in this field. ^{4 5} If your baby is receiving formula and seems not to be tolerating it well, your health visiting team or GP can help you explore this further.

If you notice a possible link between your baby’s symptoms and something you eat or drink, you could try reducing that food to see whether symptoms improve. Our food allergies article has more information.

Treatments for severe reflux

You might wonder whether switching to formula would help your baby. This is very unlikely to help, and may make the symptoms worse. While both breastfed and formula fed babies can experience reflux, research has shown that formula fed infants have episodes of reflux more often than breastfed babies, and they last longer. 

As one cause of reflux can be a delayed emptying of the stomach, the fact that human milk leaves the stomach around twice as quickly as formula means that breastmilk lessens the possibility of reflux. 

The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommends that for babies with reflux, “breastfeeding should never be discontinued in favor of formula feeding”. ⁶

Thickeners

The first medical treatment sometimes suggested for reflux is an alginate (seaweed-based) preparation, which forms a layer on top of the stomach contents and may help reduce milk coming back up.

For breastfed babies, this can be given mixed with a small amount of cooled, boiled water, using a spoon or oral syringe. Most babies tolerate the taste well. Because alginates thicken stomach contents, they can also make stools firmer and may lead to constipation. Some parents find that adjusting the dose can help balance reflux symptoms with this side effect. ⁷

Thickened formula milks are sometimes suggested for formula-fed babies. These are not suitable for breastfed babies and may increase the risk of contamination, as the water used to mix them cannot be heated to the 70°C recommended to kill harmful bacteria ^{8 9}, as well as excessive weight gain. ¹⁰

Acid-reducing medications

If an alginate does not improve symptoms, medication to reduce stomach acid may sometimes be considered. These medicines can help reduce irritation in the oesophagus, but they do not stop reflux from happening.

They are stronger treatments with potential side effects, so are usually only recommended when symptoms are severe or persistent, and after other approaches have been tried.  In these situations, your baby may be referred to a paediatrician or paediatric gastroenterologist for further assessment. ¹¹

Surgery

Very rarely, babies with severe reflux that does not respond to other treatments may be considered for surgery to help prevent stomach contents flowing back into the oesophagus.

Support for you

It’s hard to care for a baby who often vomits, or who is uncomfortable and unhappy. Many parents in the LLL community have been through this, and you are not alone. LLL Leaders and groups can offer understanding and support as you find what works for you and your baby.

If this article has helped you, please consider supporting LLLGB with a donation. Every gift, however small, helps keep breastfeeding information and support flowing.

Further Reading

References

1. NICE (2015, updated 2019) Gastro-oesophageal reflux disease in children and young people: diagnosis and management (NG1). https://www.nice.org.uk/guidance/ng1  (Accessed 18 March 2026). ↩︎
2. NICE (2024) GORD in children. Clinical Knowledge Summaries. 
   https://cks.nice.org.uk/topics/gord-in-children/ (accessed 18 March 2026) ↩︎
3. Leung, Alexander Kc, and Kam Lun Hon. “Gastroesophageal reflux in children: an updated review.” Drugs in contextvol. 8 212591. 17 Jun. 2019, doi:10.7573/dic.212591 https://pmc.ncbi.nlm.nih.gov/articles/PMC6586172/ (accessed 18 March 2026) ↩︎
4. Allen, Hilary I et al. “Prevalence and risk factors for milk allergy overdiagnosis in the BEEP trial cohort.” Allergy vol. 80,1 (2025): 148-160. doi:10.1111/all.16203
   https://onlinelibrary.wiley.com/doi/10.1111/all.16203 (accessed 18 March 2026) ↩︎
5. Allen, Hilary I et al. “Detection and management of milk allergy: Delphi consensus study.” Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology vol. 52,7 (2022): 848-858. doi:10.1111/cea.14179
   https://onlinelibrary.wiley.com/doi/10.1111/cea.14179 (accessed 18 March 2026) ↩︎
6. Haiden et al. (2024) Infant formulas for the treatment of functional gastrointestinal disorders: A position paper of the ESPGHAN Nutrition Committee.
   https://bspghan.org.uk/wp-content/uploads/2024/05/infant-formulas-for-the-treatment-of-functional-gastrointestinal-disorders-a-position-paper-of-the-espghan-nutrition-committee.pdf (accessed 18 March 2026) ↩︎
7. NICE (2024) Gaviscon® Infant. Clinical Knowledge Summaries: GORD in children.
   https://cks.nice.org.uk/topics/gord-in-children/prescribing-information/gavisconr-infant/  (Accessed 18 March 2026). ↩︎
8. First Steps Nutrition Trust (2021) Thickened (anti-reflux) infant milks suitable from birth.  
   https://infantmilkinfo.org/wp-content/uploads/2024/07/Anti-Reflux_Infant-Milk_October-2021.pdf (accessed 18 March 2026) ↩︎
9. Kwok TC, Ojha S, Dorling J. Feed thickener for infants up to six months of age with gastro‐oesophageal reflux. Cochrane Database of Systematic Reviews 2017, Issue 12. Art. No.: CD003211. DOI: 10.1002/14651858.CD003211.pub2. https://www.cochrane.org/evidence/CD003211_feed-thickener-infants-six-months-age-gastro-oesophageal-reflux (accessed 18 March 2026). ↩︎
10. Allen, Hilary I et al. “Detection and management of milk allergy: Delphi consensus study.” Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology vol. 52,7 (2022): 848-858. doi:10.1111/cea.14179
    https://onlinelibrary.wiley.com/doi/10.1111/cea.14179 (accessed 18 March 2026) ↩︎
11. NICE (2024) Omeprazole. Clinical Knowledge Summaries: GORD in children.
    https://cks.nice.org.uk/topics/gord-in-children/prescribing-information/omeprazole/ (accessed 18 March 2026) ↩︎