What is it?
Gastro-oesophageal reflux , also known as ‘spitting up,’, ‘possetting’, or ‘regurgitation’, describe the action of the stomach contents moving back up into the gullet (oesophagus) or mouth. It is not uncommon for regurgitation to occur in babies during and immediately after meals because they are taking large volumes of milk and food to support their rapid growth rate. In most babies, gastro-oesophageal reflux disappears by about 12 – 15 months of age.
Bringing back feeds occasionally shouldn’t concern you if there are no other symptoms, particularly if your baby is growing well and seems happy. There is a risk, however, that if gastro-oesophageal reflux persists past the age of 18 – 24 months, it may progress into Gastro-oesophageal reflux disease. This needs to be treated as it can irritate and damage the lining of the oesophagus. This is because the feed that comes back up from the stomach contains acids (which digest the food in the stomach) that irritate the oesophagus lining. The regurgitated feed may also go into the lungs, and cause chest infections.
What are the symptoms?
Symptoms of Gastro-oesophageal reflux to look out for include: 
- Regular vomiting
- Excessive crying
- Poor growth may occur
- Poor sleep
- Food refusal
In addition to the symptoms above, symptoms of gastro-oesophageal reflux disease include
- Constant coughing
- Frequent chest, ear and sinus infections
What causes it?
The oesophagus of a baby is quite short. A baby’s stomach is also very small in size and does not stretch very easily. If babies are given a large amount of feed, it can make their stomachs overflow and the feed return back up the oesophagus, causing them to spit up or vomit.
The way a baby is fed can also contribute to gastro-oesophageal reflux. For example, using formula feeds made up in the wrong concentration, or delivering feeds too quickly, could cause gastro-oesophageal reflux.
How is it treated?
If you suspect your baby has gastro-oesophageal reflux disease, you should take them to your GP.
There are a number of tips for dealing with gastro-oesophageal reflux:
- Wind your baby in the middle and the end of a feed. (Click here for more information on winding section)
- Hold your baby in an upright position for about 20 minutes after feeding to help with their digestion
- If feeding formula, make sure you follow the instructions on the label when making up the formula
- Try giving smaller, more frequent feeds, but be careful not to increase or reduce the overall amount of feed given each day
- Sometimes, parental anxiety can make gastro-oesophageal reflux worse. If you feel this may be the case, talk to your health visitor to get reassurance you need
Feed thickeners may help to keep the feed down. For breastfed babies, a thickener can be mixed with some expressed breast milk or cooled boiled water and given as a thick paste by spoon or cup, both before and in the middle of a feed. Your baby may need to take some medication such as antacids alongside the thickened feeds, so it’s important to speak to your GP or health visitor for more information about this.
For formula fed infants, a feed that contains a precooked starch may be useful. This works by thickening in the baby’s stomach. Your GP or health visitor can advise you on this and can prescribe a formula for this purpose.
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