About gastro-oesophageal reflux and GORD
Gastro-oesophageal reflux is when food or milk from your child’s stomach comes back up their food pipe or mouth.
Reflux is very common in young babies because the muscles at the top of their stomachs aren’t strong enough to keep food or milk down. It usually gets better with time as children start to eat solids, sit up for longer, and develop stronger stomach muscles.
Most babies who bring up milk are healthy. Reflux is usually nothing to be concerned about.
Rarely, babies might have complications from reflux. When this happens, it’s known as gastro-osophageal reflux disease (GORD).
Symptoms of gastro-oesophageal reflux and GORD
If your child has gastro-oesophageal reflux, they’ll vomit milk or food. This can happen during, between and after feeds.
Reflux usually doesn’t cause babies any pain or problems with weight gain.
But if your child has GORD, they might vomit milk frequently and also have symptoms like:
- choking, coughing or wheezing during feeds
- blood in their vomit
- distress during feeds
- refusal to feed
- poor weight gain or weight loss.
Vomiting is a key symptom of reflux. If your child isn’t vomiting but cries a lot, pulls up their legs or knees, or arches their back, it’s best to see your GP, paediatrician or child and family health nurse. They can rule out other medical causes and help you with settling strategies.
Does your child need to see a doctor about gastro-oesophageal reflux and GORD?
You should see your GP if your child:
- finds it difficult to swallow
- has a fever
- is irritable and difficult to settle a lot of the time
- won’t eat
- is vomiting a lot
- isn’t growing properly or is losing weight
- has a chronic cough or recurrent chest infections.
If your child has severe GORD, your GP might refer you to a gastroenterologist.
Take your child to a hospital emergency department if they have blood in their vomit or their vomit is green.
Tests for gastro-oesophageal reflux and GORD
Usually, your child won’t need any tests for reflux.
If your child has severe GORD, a gastroenterologist might do an endoscopy and/or gastroscopy. These procedures involve using a flexible tube to look at the structure and lining of your child’s food pipe. They’re done under a general anaesthetic.
The gastroenterologist might sometimes recommend pH monitoring to check whether there’s too much acid in your child’s food pipe. This is done by placing a tiny tube with a sensor in your child’s food pipe for 24 hours.
Treatment for gastro-oesophageal reflux and GORD
Most cases of gastro-oesophageal reflux get better by themselves with time and don’t need treatment. But there are a few things that might help in the meantime.
You could try keeping your child upright for 10 minutes after a feed to ease the problem.
Your doctor might suggest thickening breastmilk or formula until the reflux gets better. Thickeners should be used only in consultation with your doctor. Your doctor will monitor your baby while you’re using thickeners.
If your child has GORD, sometimes your doctor might recommend over-the-counter or prescription medicines to reduce your child’s symptoms.
You should follow safe sleeping practices, even if your baby has reflux. This means putting your baby on their back to sleep. Your baby should sleep on a firm, flat mattress that isn’t elevated in any way.