HealthInfo Canterbury
Spilling (reflux) in babies
Spilling (reflux) is when the baby's stomach contents pass up into their food pipe or gullet (oesophagus) and into their mouth. Spilling is quite common in babies, and is different to vomiting, when the baby empties their stomach forcefully.
It's usually worst at 4 months and gets better by the time your baby is 12 months old.
If your baby spills, there is no need to be worried as long as they are growing well. Tests and medications are not normally needed. In fact, medications can be harmful for young babies.
Causes of spilling (reflux) in babies
A muscle valve at the top of our stomach keeps the food and fluids in. In babies, this valve can be quite loose, so stomach contents come back up into their food pipe more easily. As your baby gets older, this muscle valve usually gets stronger and stops the spilling.
Rarely, an allergy to cow's milk (often called a dairy allergy) causes the spilling. It's not usually necessary to change formula or stop having dairy foods. Talk to your GP, Well Child provider, or midwife before making any changes.
Treating spilling (reflux) in babies
It can be hard to know if spilling is making your baby unsettled, as being unsettled is common with all babies. Read more about how to help unsettled & crying babies.
If your baby spills a lot, there are some things you can do to help.
- Dress or change your baby before feeds when their stomach is not full.
- Wind your baby several times during feeds.
- Use a towel to cover yourself and to put under your baby, and use large bibs to catch the spills.
- Keep your baby upright after a feed for a short time.
- Try propping up the head of the bassinet or cot. Make up the bed with your baby's feet at the bottom, so they cannot slide under the blankets. Make sure your baby always sleeps in a safe position on their back, to prevent sudden unexpected death in infants (SUDI, also called SIDS). Do not let a baby sleep on their tummy or side.
If your baby spills and is also not growing, feeding or sleeping well, your doctor may suggest you try giving a thickener in their milk.
In the past, people gave medicines such as omeprazole or ranitidine for spilling. These are no longer used unless recommended by a child specialist (paediatrician). They don’t help most unsettled babies and can increase the risk of serious illnesses such as pneumonia and gastroenteritis.
Getting help with spilling (reflux) in babies
In most cases if your baby is growing well there is no reason to worry about spilling. But if they're not growing, feeding, or sleeping well, you should get them checked by your GP or Well Child provider.
Your baby always needs to be checked by a doctor if they:
- start to vomit and there is blood or bile (green or yellow colour) in the vomit
- are not growing well, or are refusing to feed
- are crying inconsolably and are irritable.
Having a baby who spills can be quite upsetting and stressful. You need to look after yourself too. Make sure you get help and support, talk to other parents, and try to get some time out.
HealthInfo recommends the following pages
- Gastric Reflux Support Network NZ – Crying Over Spilt Milk
Information and support for parents whose children spill
- KidsHealth – Reflux
More information about reflux and when you need to get help
- Plunket – Reflux
Information about reflux, with details of how to contact Plunket's 24-hour support line
Written by HealthInfo clinical advisers. Last reviewed October 2021.
See also:
Review key: HIUCB-33560
