Baby Reflux & Silent Reflux: Signs, Settling and When to See a GP

Most babies bring milk back up. That''s normal. What sends parents searching at 2am is the harder version — the arching, the screaming after feeds, the silent kind where nothing comes up but baby is clearly in pain. This guide separates everyday reflux from the reflux that needs a GP, and gives you the settling steps a Maternal Health Nurse would walk you through first. Reflux vs silent reflux vs GORD — the quick version Reflux GOR is when stomach contents come back up the food pipe. In babies it''s incredibly common because the valve at the top of the stomach is still maturing. Up to half of all babies under 3 months posset gentle spit-up after feeds. It usually peaks around 4 months and most babies grow out of it by 12 months. Silent reflux is the same physical event — but instead of milk coming up and out, it comes up and is re-swallowed. Nappy and bib stay clean, so it''s easy to miss. You see the signs in baby''s behaviour : arching back during or after feeds, sudden screaming, swallowing repeatedly, gulping, sour breath. GORD Gastro-Oesophageal Reflux Disease is reflux that causes damage or interferes with feeding and growth . It''s much rarer. GORD is what your GP is checking for when reflux comes with poor weight gain, blood in vomit, refusing feeds, or persistent breathing problems. How to tell the difference at home Use this quick mental checklist before you assume the worst: Happy spitter — brings milk up, then smiles. Weight gain is fine. This is normal reflux and needs reassurance, not treatment. Unhappy refluxer — vomits or arches, cries during feeds, hates lying flat, fights sleep. Weight gain still on track. This is reflux that needs settling support , not necessarily medication. Possible GORD — refusing feeds, losing weight or not gaining, blood in vomit, persistent cough or wheeze, choking episodes. See a GP within a few days. What actually helps — the settling steps that come before medication Australian guidelines the Royal Children''s Hospital Melbourne and the Australasian Society for Paediatric Gastroenterology are clear: for most babies, simple feeding and positioning changes work before any medication is needed. Try these in order: 1. Smaller, more frequent feeds An overfull stomach is a refluxing stomach. If you''re bottle feeding, drop the volume by 20–30 mL and offer the feed more often. If you''re breastfeeding, offer one breast…