Tips and videos for infant and baby reflux

Digestive Issues: reflux

expert tips & videos

Tips for infant reflux

Reflux is when your baby spits up breastmilk or formula. Most babies have some degree of reflux, especially in the first several months of life as the lower esophageal sphincter is still developing. Most babies are “happy spitters” meaning spitting up doesn’t bother them. The amount they spit up usually looks like way more than it actually is—just a teaspoon of liquid can make their clothes look soaked.

Tips for Reflux in Babies

reduce air intake & speed of milk

Reclined nursing: If you have a fast letdown or flow, your baby may guzzle or choke and pull off the breast, causing excess air intake which can push food upwards as air bubbles rise. Try reclining while you nurse to slow your flow by working against gravity. You can also try using a milk collector during letdown and switch to nursing once your flow slows a bit.

Paced bottle feeding: Use a smaller bottle nipple size, hold baby upright, and hold bottle at 45° angle (not straight up) while feeding to slow milk flow. This helps baby avoid guzzling and losing their latch, which can cause excess air intake.

Burping: Burp your baby when you switch breasts or every 2-3 oz, and again at the end. If your baby doesn’t burp, try laying them on their back for a couple minutes and try again. Don’t worry if it still doesn’t happen— sometimes they just don’t burp.

Keep baby upright for feedings

During feedings, keeping baby upright or inclined (not horizontal) can help gravity bring the milk down the esophagus.

After feedings, keep baby upright for 20-30 minutes to help milk stay down.

Use a pacifier (maybe)

Some research shows pacifier use may help reflux by prompting swallowing (causing downward contractions of the esophagus) and gastric emptying (food leaving stomach to small intestine).

Try smaller, more frequent feedings

This helps avoid unintentional overfeeding, which can make spit up worse.

Only try if your baby is 1+ month and gaining weight well.

Have burp cloths, bibs & extra clothes handy

The tips here can help reduce spitting up but won't make it go away entirely. Until your baby grows out of it, be ready for the cleanup.

AAP safe sleep tip!

Continue laying baby on their back on a flat (not inclined) crib or bassinet to sleep. This does NOT increase risk of choking on spit up.

Other tips to consider if needed

Try adjusting your diet

Some are quick to blame a breastfeeding mom’s diet for any digestive challenges her baby has, but there is limited conclusive evidence linking the two. Still, it makes sense to pay attention to whether your baby seems fussier after you eat certain foods, such as dairy. If you notice any patterns, try removing these specific foods (one at a time) to see if it makes a difference.

Try gas drops or a probiotic

Gas drops (simethicone) can help break down gas bubbles while probiotic drops are meant to improve digestive health over the longer term, which some say helps ease digestive issues. There’s not much evidence showing whether either of these actually work, but they are safe and lots of parents like them so it could be worth a shot.

When to call your pediatrician

You don't need to check any of the boxes below – call whenever you have any questions or concerns about your baby!

Fussiness or excessive crying during or after feeds or when spitting up

Frequent choking or gagging on milk

Forceful or projectile vomiting

Green, yellow, or bloody spitup

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