Causes of gastro-oesophageal reflux

Reflux happens when the muscles between your baby’s food pipe (or oesophagus) and tummy relax for a moment. This lets tummy contents come back up from her tummy into her food pipe or mouth.

In babies, it’s common for these muscles not to be fully developed. This results in a type of vomiting or spitting called ‘posseting’.

Symptoms of gastro-oesophageal reflux

If your baby has gastro-oesophageal reflux, you’ll usually see reflux symptoms within the first month after birth. Your baby might start to vomit milk – this can happen during, between and after feeds.

Most children with reflux grow out of it by the time they’re toddlers. This is probably because they’re spending more time in an upright position by this age. They’re also eating more solid foods. A few children keep having symptoms after the toddler period.

Gastro-oesophageal reflux disease (GORD)
In some babies and children, reflux very occasionally leads to complications. In this case, your doctor might diagnose your child with gastro-oesophageal reflux disease (GORD).

GORD symptoms include pain and discomfort in the chest or upper abdomen, which might make your baby cranky. Your baby might cry a lot or arch his back.

If your baby has GORD, her sleep might be disrupted sometimes, or she might show poor weight gain. You should also look out for a chronic cough and wheeze.

When to see your doctor about gastro-oesophageal reflux

You should see your doctor if your child:

  • has bile (green fluid) or blood in his vomit
  • finds it difficult to swallow
  • has a fever
  • is irritable and difficult to settle a lot of the time
  • won’t eat.

Tests for gastro-oesophageal reflux

Usually, your child won’t need to have any tests for reflux.

In a few children, particularly those who have reflux complications or GORD, doctors might recommend pH monitoring (checking the level of acid) to see whether there’s too much acid from the stomach in the oesophagus. This is done by placing a tiny tube with a sensor in the baby’s oesophagus for 24 hours.

Sometimes the doctor might want to look at the lining of the oesophagus using a special camera. This test is called an endoscopy and is done under anaesthetic.

Treatment for gastro-oesophageal reflux

Most cases of gastro-oesophageal reflux get better by themselves with time and don’t need treatment.

If your baby’s reflux is mild, and her weight gain isn’t affected, you could try feeding her in a more upright position to ease the problem. Try keeping her upright for about 30 minutes after feeds.

Your doctor might recommend thickening your baby’s formula or using prethickened formula if your baby is formula fed. For breastfed babies, the doctor might suggest thickening breastmilk with rice cereal or a thickening agent.

If your child seems to be in pain after vomiting, or isn’t gaining enough weight, your doctor might prescribe an acid suppressant.

Your doctor can advise you on the most appropriate treatment for your baby. It’s always advisable to consult your doctor if your baby is vomiting a lot with feeding.

You should follow safe sleeping practices, even if your baby has reflux. This means putting your baby on his back to sleep. He should sleep on a firm, flat mattress that is not elevated in any way.