What is baby reflux?

In a small number of cases, reflux may indicate underlying issues including GORD, allergies or in very rare cases, blockages. GORD which stands for Gastro-oesophageal reflux disease is a more severe form of reflux where stomach acid irritates the oesophagus and can cause symptoms of discomfort for the baby.

An allergy to cow’s milk can cause reflux and is likely to occur alongside other symptoms like rash, vomiting, and diarrhoea. Many babies outgrow this allergy, and symptoms improve when cow’s milk is removed from their diet.

In very rare cases, reflux may be due to issues in the development of the oesophagus, or a blockage in the stomach or small intestine. If you suspect any of these less common causes of reflux, further medical support is advised. Some reflux is normal and if your baby is gaining weight and seems healthy, it does not need to be treated.

Understanding the different types of reflux in babies can help parents identify the specific condition their baby might have.

There is a known link between baby reflux and allergies, particularly cow's milk protein allergy and other food allergies. Introducing allergens to babies is an important step in preventing food allergies, as research has shown that early introduction can reduce allergies, such as peanuts and eggs.

Current guidelines suggest introducing common allergens early, from around 6 months. It is important that the baby is developmentally ready for solid foods, meaning they should be able to sit with support, hold their head up, and show interest in food.

There are nine main food allergens commonly associated with allergic reactions, including peanuts, tree nuts such as almonds, walnuts, and cashews, cow’s milk, eggs, fish, shellfish like shrimp and crab, wheat, soy, and sesame. In addition to these, there are other less common allergens such as mustard, lupin, and celery, but the ones listed are the most widely recognised.

When introducing allergens, it is recommended to introduce one at a time in a small amount and monitor your baby for any reaction. It is important to leave a gap of three to five days before trying another. Your baby should be healthy and free of illness when introducing new foods.

Current guidelines suggest that if your baby is at high risk for allergies (e.g. has severe eczema or a family history of allergies), consult with your GP before introducing allergens. Signs of a food allergy can include 1 or more of the following reactions: diarrhoea or vomiting, coughing, wheezing and shortness of breath, itchy throat and tongue, itchy skin or rash, swollen lips and throat, runny or blocked nose and sore, red and itchy eyes. If your baby displays any severe allergic food reactions, call 999 and get medical help immediately.

Introducing allergens under the right circumstances can help reduce anxiety, reduce the risk of developing food allergies and support a healthy, diverse diet for your child.

Reflux is often nothing to worry about as long as your baby is happy, healthy, and is gaining weight. However, it is important to seek guidance from a midwife, public health nurse, lactation consultant, health visitor, or GP if reflux begins after six months of age, continues beyond one year, or if you have concerns about the symptoms they are experiencing.

If your baby frequently spits up feeds or refuses to feed, coughs or gags while feeding, or experiences frequent projectile vomiting, it may indicate a more serious issue. Excessive crying or irritability, green or yellow vomit, or the presence of blood in vomit or stools should also be investigated. Other concerning signs include persistent diarrhoea or chest infections, a swollen or tender tummy, a high temperature of 37.5°C (99.5°F) or higher, or difficulty gaining weight.

Most cases of reflux in babies improve with time and some feeding adjustments. If your baby’s symptoms cause concern, trust your instincts and contact your midwife, health visitor, public health nurse, lactation consultant or GP.