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.. see also The Infant with Gastro-oesophageal reflux (pdf)

Website: www.reflux.org.au/management.php

Reflux in infants 

What is gastro-oesophageal reflux?

Reflux is where the food in the stomach overflows back into the oesophagus (gullet). It often causes a baby to bring up or vomit milk after a feed.

A mild degree of reflux is normal in babies, especially after they burp; this condition is called positing. However, the reflux can be quite severe in some babies, who appear to vomit after their bottle or breastfeeding.

What are the symptoms?

Milk will flow freely from the mouth soon after feeding, even after the baby has been put down for a sleep. Sometimes the flow will be forceful and may even be out of the nose.

Despite this vomiting or regurgitation, the babies usually are comfortable and thrive. Some infants will cry, presumably because of heartburn.

What is the outlook?

Reflux gradually improves with time and usually ceases soon after solids are introduced into the diet. Most cases clear up completely by the age of 9 or 10 months, when the baby is sitting. Severe cases tend to persist until 18 months of age.

Contact your doctor should any unusual symptoms appear, such as green or blood-stained vomit, projectile vomiting, or if your baby is distressed after feeds or stops putting on weight.

What is the treatment?

Simple home measures

The stomach can empty more quickly by elevating the head of the cot or placing the child upright in a suspended 'swing' for periods of about 30 minutes after feeds when awake. The old 'bucket' method, in which the child is placed in a bucket, is not necessary.

Thickening of feeds

Giving the baby thicker feeds usually helps those with more severe reflux. The old-fashioned remedy of using cornflour blended with milk in bottles is still useful.

Bottle-fed babies (powdered milk formula)

• Carobel:       Add slightly less than 1 full scoop per bottle.
• Gaviscon:      Mix slightly less than ((g)) teaspoon of Infant Gaviscon Powder with 120 mL of formula in the bottle.
• Cornflour:      Mix 1 teaspoon with each 120 mL of formula. Check with your doctor or  nurse for the proper method.

Breastfed babies

• Carobel:      Add slightly less than 1 full scoop to 20 mL cool boiled water or 20 mL expressed breast milk and give just before the feed.
• Gaviscon:      Mix slightly less than ((g)) teaspoon of Infant Gaviscon Powder with 20 mL cool boiled water or expressed breast milk and give just after the feed.

Key points

• Reflux:
• is common
• improves with age
• usually clears up by 9 months of age
• is helped by elevating the cot
• is helped by thickening the feeds
  

  Copyright 1995: John Murtagh, Professor of General Practice
  Monash University, Melbourne, Australia