Reflux

You should: 

• Offer your baby smaller volumes more frequently. If your baby is breast-feeding then you should expect to see at least 6 wet nappies a day and they would be gaining weight of a minimum of 500g per month. Your health visitor will be able to help give advice about how much formula milk your baby should take and how often. 
• Keep your baby upright for half an hour after feeds; a fabric sling might help 
• Use a baby chair or infant bean bag, with your baby secured safely, to help keep them at an angle between feeds.  Do not use a car seat as this may compress their stomach 
• Use a rolled towel or wedge under the head end of the cot or basket they lie in, to let gravity help keep the milk down.  Remember to always place your baby on their back when sleeping, with their feet at the foot of the cot.

Gastro-oesophageal Reflux Disease (GORD) often peaks before the age of 6 months, and gradually gets better. Most babies will be better by the time they are 12-18 months of age, whether they have had treatment or not. 

No single medication will cure GORD but your doctor will discuss medicines with you if reflux is a serious problem for your baby, such as if they are not growing or feeding properly.  

Vomiting can occasionally be a sign of a more serious problem. Use the traffic light table below to find out when and where to get help if your baby is unwell.

If your baby has any of the following:  Green vomit (like the colour of spinach or green washing up liquid)  Becomes pale, mottled or abnormally cold to touch  Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless within 48 hours of vaccinations) or 3-6 months of age with a temperature of 39°C or above  Is breathing faster than usual  Is agitated or will not stop crying even after being comforted  Becomes floppy or difficult to wake  Becomes stiff for a prolonged period or has jerking movements of arms or legs that do not stop when you hold their limbs (a seizure)  Lips are going blue or has difficulty breathing  A rash that does not disappear with pressure (see the “Glass Test”)

You need urgent help. Go to the nearest Hospital Emergency Department or phone 999

If your baby has any of the following:  Vomits forcefully (shoots across the cot or the room)  Becoming increasingly sleepy and not consistently waking for feeds  No wet nappies in the last 8 hours  Has a dry mouth or flattened soft spot on their head  Ongoing vomiting with blood in the vomit or poo  Is getting worse or you are worried	You need to contact a doctor or nurse today. Please ring your GP surgery or call NHS 111 - dial 111

If none of the above features are present and your baby:  Continues to feed well  Has plenty of wet nappies (at least 6 in a 24 hour period)  Wakes up regularly for feeds	Self care Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

References:

1. 1 Recommendations | Gastro-oesophageal reflux disease in children and young people: diagnosis and management | Guidance | NICE 
2. CS48256_NHS_Feeding_-_Additional_Notes_GOR_and_GORD_Oct_18_.pdf (what0-18.nhs.uk)