HealthInfo West Coast-Te Tai Poutini

Spilling (reflux) in babies

Te maringi, te ruaki me mate ruaki ki ngā pēpi

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 pēpi (babies). It is different to vomiting, when the pēpi empties their stomach forcefully.

It is usually worst at 4 months and gets better by the time your pēpi is 12 months old.

If your pēpi 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 pēpi.

Causes of spilling (reflux) in babies

A muscle valve at the top of our stomach keeps the food and fluids in. In pēpi, this valve can be quite loose. This means that stomach contents come back up into their food pipe more easily. As your pēpi 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 is not usually necessary to change formula or stop having dairy foods. Talk to your general practice team, 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 pēpi unsettled, as being unsettled is common with all pēpi. Read more about how to help unsettled & crying babies.

If your pēpi spills a lot, there are some things you can do to help.

• Dress or change your pēpi before feeds when their stomach is not full.
• Wind your pēpi several times during feeds.
• Use a towel to cover yourself and to put under your pēpi. Use large bibs to catch the spills.
• Keep your pēpi upright for a short time after a feed.
• Try propping up the head of the bassinet or cot. But make up the bed with your baby's feet at the bottom end, so they cannot slide under the blankets. Make sure your pēpi always sleeps in a safe position on their back to prevent sudden unexpected death in infants (SUDI, also called SIDS). Do not let a pēpi sleep on their tummy or side.

If your pēpi spills and is also not growing, feeding or sleeping well, your health provider may suggest you try adding a thickener to 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 do not help most unsettled pēpi and can increase the risk of serious illnesses such as pneumonia and gastroenteritis.

Getting help with spilling (reflux) in babies

If your pēpi is growing well there is usually no reason to worry about spilling. But if they are not growing, feeding, or sleeping well, you should get them checked by your general practice team or Well Child provider.

Your pēpi always needs to be checked by a health professional 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 pēpi 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 tamariki (children) spill.

• KidsHealth – Reflux

  More information about reflux and when you need to get help.

• Plunket – Reflux

  Information about reflux. Includes details of how to contact Plunket's 24-hour support line.

Written by HealthInfo clinical advisers. Last reviewed December 2024.

Sources

Page reference: 37753

Review key: HIUCB-33560