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Relieving GOR & GORD

As a Mum, you’ll likely know that spitting up milk is common. If your baby is happy and growing, it’s usually nothing to worry about. But sometimes, these symptoms can be an indication of something more. Here’s how to understand the symptoms of reflux, and how to help your child find relief.

What You Need to Know About Baby Reflux

  • Gastro-oesophageal reflux (GOR) occurs when your baby ‘spits up’ the contents of their stomach, back into the food pipe or mouth.
  • Reflux symptoms generally begin within a baby’s first month. Most babies will grow out of reflux by the age of one.
  • In most cases, reflux is not a reason for concern and doesn’t require treatment.
  • However, in some instances, the acid can cause heartburn and in severe cases damage the lining of the oesophagus, leaving it inflamed. This is known as gastro-oesophageal reflux disease (GORD). If your baby can feel pain or discomfort when they bring up milk, visit your doctor.

What Is Reflux in Babies?

Does milk spill out of your baby’s mouth after a feed? For almost half of babies, reflux (also known as gastro-oesophageal reflux [GOR] or acid reflux) happens when a baby vomits or spits up stomach contents (e.g. breastmilk) into the food tube or mouth. This is also called posseting. Generally, simple reflux won’t hurt your child and clears up on its own by the age of 18 months. If your baby is otherwise happy and putting on weight, this is called simple reflux and is unlikely to cause pain, discomfort or future problems.

Here are some key definitions to help you understand your baby’s reflux –

  • The oesophagus is a muscular tube (the food pipe) leading from the mouth to the stomach.
  • At the bottom of the oesophagus, there is a ring of muscle which opens when you swallow. This ring of muscle is called the lower esophageal sphincter(LES).

In infancy, the LES is not fully developed. This can cause the LES to relax or not close fully, causing regurgitation of stomach contents and acid. As your child grows, the LES will strengthen and develop to remain firmly closed when they are not swallowing, keeping stomach contents where they belong.

GORD in Babies

In some children, reflux can very occasionally lead to more worrisome symptoms which indicate GORD. Gastro-oesophageal reflux disease (GORD) is a complication of GOR. If your baby has been diagnosed with GORD, they may feel pain and discomfort, as the acid can cause heartburn and damage the oesophagus lining. If your baby is showing symptoms of GORD or experiencing reflux for longer than a year, seek treatment.

Silent Reflux Baby

Silent reflux is not a medical diagnosis, and there is no scientific evidence to support this. If you are unsure of what your child’s symptoms may mean, it is best to speak to your child’s doctor.

Baby Reflux Symptoms

All children are different, and the below symptoms may not indicate your child’s condition. If you are unsure, it is always best to check with your child’s doctor.

Type of Reflux Symptoms
Reflux/GOR
  • Vomiting during, between and/or after feeds
  • Wet burps or hiccups
GORD (see your baby’s doctor)
  • Poor weight gain
  • Difficulty sleeping and/or settling
  • Chronic difficulty breathing including coughing, wheezing or recurrent pneumonia
  • Feeding difficulties:
    • Difficulty swallowing, including gurgling or drooling more than usual
    • Irritability crankiness or inconsolable crying during or after feeding
    • Gagging or choking
    • Refusing to eat
    • Vomiting a lot
  • Signs of pain or heartburn in the chest or stomach, such as abnormal arching of the back
  • Blood or yellow fluid in their vomit
  • Fever

Reflux Causes

Reflux is equally common in formula-fed and breastfed babies. The factors contributing to any kind of reflux often can’t be avoided:

  • Spending a lot of time lying on the back especially before they learn to roll over at 4-6 months of age. Even if your baby has reflux, you should always put your baby to bed on their back.
  • Consuming a mostly liquid diet; liquids are easier to spit up than solid food.

How to Help a Baby with Reflux at Home

Mild Reflux:

If your baby frequently spills up but it doesn’t concern them, you can do the following:

  • Feed your baby upright.
  • Hold them in a sitting position for 30 minutes after feeding. You can use a pillow to prop them up when they’re playing on the floor or during a nappy change.
  • Don’t bounce your baby for at least 20 minutes after a feed, to allow time for their stomach to settle.
  • Burp your baby during and after feeding. Just keep plenty of burp cloths handy!
  • If you’re bottle feeding, hold the teat on an angle so it stays full of milk. This will help your baby gulp less air, reducing intestinal pressure which can lead to reflux.

Moderate Reflux:

If your baby is experiencing discomfort, but still growing well, you can use the suggestions above as well as the following:

  • If they are fussy when feeding, try to have a break when they begin fussing. Wait around 15 to 30 minutes then re-offer the feed.
  • Try giving smaller, more frequent feeds as some babies do well with less milk. However, be careful to keep track of their weight.
  • To help alleviate reflux, your doctor may recommend a specially developed feed thickener to add to your breast milk or formula, or a pre-thickened formula.

GORD

Your baby may find comfort from some of the suggestions for mild or moderate reflux.

Thickening feeds may not reduce acid and are usually a way of managing mild to moderate reflux and not GORD.

When to See a Doctor

Most babies with reflux do not require treatment. However, if your child is healthy but has reflux and you are still concerned, visit your GP or Maternal and Child Health Nurse.

See your GP if your baby has any problems, or is showing symptoms of GORD. The doctor will check your child’s development and if necessary, refer you to a pediatrician or recommend treatment or medication. The options for treating reflux in a baby depends on age and severity.

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