Most babies spill. The ones who are miserable with it have a reason.
Two pages on reflux in babies from birth to five months. What the spills mean, what makes some babies miserable with them, and the eight changes that help in the first week while you work out the cause.
Where should we send it?
Two pages, free.
- Eight changes for the first week
- Who helps with what
- Safe sleep, and the red flags
What is in the guide
Two pages. One on what is driving it, one on what to do while you work that out.
What is happening
- The difference between a happy spitter and a baby whose reflux needs looking at, with the signs that separate them
- Five things that drive it in young babies: volume and pace, swallowed air, cow’s milk protein allergy, the developing microbiome, and pressure from below
- Why swapping formula every few days gives you no clear answer, and how long a change actually needs
- What the infant studies show on reflux medication, and why a regular review with the prescriber matters
What to do
- Eight changes that help in the first week, with the reason each one works, from upright time after feeds to paced bottle feeding
- Four questions that point at the driver, so you are investigating rather than guessing
- Safe sleep with reflux, and why a raised cot end is not the answer
- Who helps with what: GP, child health nurse, lactation consultant, paediatrician, dietitian and naturopath
- The signs that need your GP or child health nurse promptly
She feeds, she screams, and it all comes back up again.
At the bottom of your baby’s oesophagus sits a ring of muscle that should stay closed after a feed. In young babies that valve relaxes often, the oesophagus is short, every feed is liquid and much of the day is spent lying down. Milk coming back up is expected, and it settles as the valve matures.
Around half of babies under three months bring up milk at least once a day. It peaks at about four months, when roughly two in three babies are doing it, and most have outgrown it by their first birthday.
A baby who brings up milk, sometimes a surprising amount, but feeds well, gains along their own growth curve and settles between feeds needs time, good feeding technique and a stack of muslin wraps. The babies worth looking at more closely are the ones who arch and cry with feeds, pull off repeatedly, feed in short fussy bursts, or only settle upright.
What drives it, and why wind and allergy look the same
Babies take in roughly 150 mL of milk per kilogram of body weight each day. Scaled up to an adult, that is more than ten litres. A small stomach plus a large or fast feed puts real pressure on a valve that is not yet holding well.
Swallowed air does the same from the inside. A shallow latch, a fast let-down, a fast teat, or starting a feed once a baby is already crying all add air, and air rising out of the stomach brings milk with it.
Cow’s milk protein allergy sits behind some of it, affecting around two to three in a hundred babies and looking almost identical to reflux. Eczema, mucus or blood streaks in stools, and allergy in the family point towards it. The developing microbiome shapes how smoothly milk moves through, and is itself shaped by caesarean birth, antibiotics in labour or the early weeks, and early formula. Constipation and trapped wind push upward from below.
Most babies have one or two of these, not all five, which is why the guide gives you questions rather than a single answer.
Safe sleep with reflux
All babies, including babies with reflux, sleep on their back on a firm, flat mattress, as recommended by Red Nose Australia.
A raised cot end does not reduce reflux, and it lets babies slide into unsafe positions. Wedges, pillows and positioners are not recommended. Upright time and tummy time happen while your baby is awake and watched.
This is the one piece of advice parents are most often given by someone well meaning, and it is worth having the current guidance in writing.
Why we made it
Most parents of a refluxy baby have already been told it is normal and they will grow out of it. Usually that is true. What it does not help with is the stretch in between, when a baby is genuinely miserable and nobody has looked at why.
So this is about finding the driver rather than managing around it. If your baby has been prescribed reflux medication, keep giving it and speak with your GP or paediatrician before changing anything. Acid suppression has a clear role when the oesophagus is inflamed, and the guide sets out what the infant studies show alongside that.
We work with families of babies from birth, alongside your GP, child health nurse, lactation consultant or paediatrician, looking at feeding, maternal diet and the developing microbiome.
Send me the guide
Free, two pages.
General information only, and not individual advice. It does not replace assessment or treatment by your baby’s doctor, child health nurse or paediatrician, and nothing here is a reason to stop or change a prescribed medication. Speak to your GP before altering any reflux medication or formula. In an emergency call 000. © The Family Naturopath, The KAN Clinic.