Reflux

Babies and birth defects

Key Points

Reflux, which causes babies to spit up more than usual, is common in preterm babies.

Most babies outgrow reflux after a few months.

You can help to reduce spitting up by changing how and when you feed your baby.

If your baby is in pain, spits up a large amount, spits up fluid that is bright yellow or green or isn’t gaining weight, talk with your baby’s provider.

All babies spit up or throw up now and then. But some do so more often than usual. This is called reflux. Reflux is short for gastroesophageal reflux or GER.

Reflux is common among preterm babies. Most babies outgrow it after a few months. Only 1 percent of babies are still spitting up after their first birthday.

Here's what happens with reflux:

  1. Food first passes through the mouth and the esophagus into the stomach. The esophagus is the tube that connects the mouth and the stomach.
  2. Once the food is in the stomach, it comes back up the esophagus and out of the mouth.
  3. Most babies with reflux grow and develop normally. But for a few babies, reflux is more serious. These babies need medication to make sure reflux is not dangerous.

How can you feed your baby if he had reflux?

If your baby had reflux in the NICU, the nurses may have shown you how to feed and position your baby to minimize spitting up. These tips may help:

  • Hold your baby upright during feeding and for 20 to 30 minutes after eating.
  • Try smaller, more frequent feedings.
  • Burp your baby often, especially if you are feeding with a bottle.
  • Try a different nipple on your baby's bottle so your baby swallows less air.
  • Ask your baby's health care provider if you can thicken the formula or expressed breast milk with a small amount of rice cereal.
  • Keep your baby still after feeding.
  • Raise the head of your baby's bed 30 degrees or so.
  • Keep a stack of cloth diapers or burp cloths handy. Use them to protect your clothes, your baby's clothes and your furniture.

If your formula-fed baby spits up more often than usual, your baby's health provider may suggest adding a small amount of baby cereal to thicken the formula. 

Can I do anything else to help my baby?

There are other things you can do to help your baby, including the following:

  • Don’t expose your baby to tobacco smoke. Babies who are around smoke have higher rates of reflux than babies who aren’t exposed.
  • If possible, breastfeed your baby. Breastfeeding may protect your baby from reflux.

When should you call your baby's health care provider?

These symptoms may mean that your baby has other problems digesting food:

  • The spit-up is bright yellow or green.
  • There is a large amount of spit-up.
  • Your baby arches their back or cries during feeding.
  • Your baby vomits with great force (projectile vomiting).
  • Your baby refuses to eat or is irritable after feeding.
  • Your baby isn’t gaining weight.
  • Your baby has problems breathing.
  • There is blood in your baby’s spit up or stool.
  • Your baby has no wet diapers for 3 hours or more.

Last reviewed: January 2024