🩺 Health · From birth to 1 year
🤮 Acid reflux or just normal spit-up?
Spit-up is common in babies and often improves as they grow. A comfortable baby who feeds and grows well may need little treatment. Persistent pain, poor feeding or poor growth deserves assessment rather than a home diagnosis of acid reflux.
What to observe
- Note whether milk comes up gently or vomiting is forceful, and whether baby seems comfortable.
- Track feeds, wet nappies and growth in the child health record.
- Arching, crying, gulping and poor sleep have many causes; they do not by themselves diagnose GERD or 'silent reflux'.
Practical feeding support
1. Follow feeding cues
Offer feeds responsively and do not pressure baby to finish a bottle. Breastfeeding, formula and mixed feeding can all be supported. Ask your clinic to review feeding technique and growth rather than choosing a universal milk quantity.
2. Pause when needed
Try a gentle burp during natural feeding pauses if baby seems uncomfortable. Not every baby burps after every feed. Avoid vigorous bouncing immediately afterwards.
3. Hold upright while awake
An upright cuddle after feeding may help some babies. Stay awake and support the head and airway. If using a carrier, follow its instructions and keep the face visible and chin off the chest; it is not a reflux treatment.
4. Avoid pressure on the tummy
Use comfortably fitted nappies and clothing. Ask a clinician before switching formula repeatedly, thickening feeds or using reflux medicines.
5. Keep sleep flat
Even with reflux, place baby on their back on a flat, firm, clear mattress in their own sleep space, in your room for at least six months. Do not use wedges, raised cot legs, pillows, side sleeping or prone sleeping.
6. Know when to get help
Seek prompt assessment for feed refusal, pain or poor weight gain. Green vomit, blood, repeated forceful vomiting or dehydration need urgent assessment. Call 999 for breathing difficulty, blue colour or floppiness. Under three months, a temperature of 38°C or higher is urgent.
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When in doubt, contact your doctor or midwife. For a life-threatening emergency, call 999.