Baby Reflux: Symptoms, Causes & When to See a GP | Parenting Hub
Reflux is common in healthy babies and usually settles by 12 months. How to tell happy spitters from reflux that needs treating, and red flags to watch.
Most babies bring up milk after feeds — it's messy but rarely a problem. Here's how to tell harmless reflux from the kind that needs help.
What it is
Reflux is when stomach contents come back up the food pipe. It happens because the muscle at the top of a baby's stomach is still developing. Around half of babies under 3 months spit up at least once a day, and most outgrow it by their first birthday.
Reflux only becomes a medical problem (gastro-oesophageal reflux disease, or GORD) when it causes pain, poor weight gain, breathing problems or feed refusal.
Symptoms
Most reflux is uncomplicated — baby is content, growing well and just brings up some milk.
- Milk coming back up during or after feeds (visible spit-up)
- Hiccups, small wet burps, or coughing after feeds
- Sometimes silent reflux — baby swallows it back down, may arch or grimace
- More noticeable when lying flat
Causes
Immature digestive systems, large feed volumes, lying flat after feeds and a fast milk flow all play a role. Cow's milk protein allergy can also look like reflux — discuss with your GP if symptoms are severe.
What helps
Small adjustments often make a real difference.
- Feed in a more upright position and keep baby upright for 20–30 minutes after
- Offer smaller, more frequent feeds rather than long ones
- Pause to burp halfway through and at the end
- Avoid bouncing or tummy-down play immediately after feeds
- Never raise the head of the cot or use wedges — flat sleep is safest
When to see a doctor
See your GP or maternal health nurse if your baby is unsettled and uncomfortable with feeds, isn't gaining weight, is refusing feeds, or if reflux is still significant after 12 months. Medication is rarely needed — most babies improve with feeding tweaks and time.
When to seek urgent care
Some signs need same-day medical assessment.
When to seek help
- Forceful, projectile vomiting after most feeds (especially under 8 weeks)
- Vomit that is green, yellow or contains blood
- Refusing feeds or losing weight
- Choking, gagging or breath-holding with feeds
- Blood in stools or persistent diarrhoea alongside reflux
Common questions
Is silent reflux real?
Yes — some babies swallow the milk back down so you don't see spit-up, but they may still be uncomfortable. Look for arching, grimacing, coughing or feed refusal rather than the mess.
Should I thicken my baby's bottles?
Only on the advice of your GP or maternal health nurse. Thickened feeds can help some babies but aren't suitable for everyone.