Most babies spit up — it’s normal and often harmless. But sometimes, reflux becomes painful or problematic, and tha’s when we look at GERD (Gastroesophageal Reflux Disease). It affects a small number of babies and may need a more supportive approach.

Common Signs of GERD

Your baby might have GERD if you notice:
• Frequent or painful spit-up after feeds
• Choking, gagging, or coughing during or after feeding
• Arching the back or stiffening (trying to relieve pain)
• Fussiness, crying, or poor sleep – especially after feeding
• Feeding struggles: refusing the breast, pulling off, or seeming hungry but upset
• Weight concerns: slow weight gain or even weight loss
• Silent reflux: no spit-up, but signs of discomfort (due to stomach contents rising and being re-swallowed)

Sometimes babies overeat to soothe the discomfort, while others avoid feeding because of the pain. It can feel like a confusing cycle for parents.

Gentle Strategies to Soothe Reflux

Feeding Tips
• Feed frequently in smaller amounts to reduce stomach pressure.
• Try upright positions: Baby’s head should be higher than their tummy.
• Reclined breastfeeding
• Koala hold (baby sitting upright on your lap)
• Side-lying (especially helpful at night)
• Allow baby to fully finish one breast before switching. Switching too soon can worsen reflux due to fast-flow milk.
• Comfort sucking at the breast (even if not for feeding) can soothe and help move milk through the tummy faster.
• Burp often, especially if baby swallows air during feeds.

Positioning & Handling
• Keep baby upright after feeds (20–30 mins).
• Try babywearing in a soft structured carrier – upright and supported.
• Avoid pressure on baby’s tummy (tight diapers, waistbands, or bouncy seats).
• For diaper changes, roll baby to the side instead of lifting legs high.

When to Talk to Your Pediatrician

Call your doctor if:
• Baby is inconsolable or extremely fussy, especially during or after feeds
• There’s poor weight gain or weight loss
• You notice green/yellow vomit, blood in spit-up, or chronic coughing
• Baby has breathing issues, frequent ear infections, or feeding refusal
• Symptoms don’t improve with basic adjustments

Diagnosis & Treatment

Many pediatricians may suggest a trial of reflux medications if GERD is suspected. Tests like a pH probe or barium swallow may be used if symptoms are severe or unresponsive to treatment. In rare, extreme cases, surgery might be considered — but most babies improve over time.

What Else Can Help?

• Breastfeeding is protective — breastmilk digests faster and causes fewer reflux episodes than formula.
• Avoid tobacco smoke exposure – it’s a known trigger.
• Limit caffeine if you’re breastfeeding.
• Talk to your provider about cow’s milk protein sensitivity, which is a hidden culprit in up to half of reflux cases.
• Don’t rush into solids or thickened feeds unless advised by your provider. Rice cereal doesn’t mix well with breastmilk and can lead to feeding challenges.

Reassurance for Parents

GERD can be distressing — for babies and their parents — but most babies outgrow it by 12–24 months. You’re not doing anything wrong. These babies just need a little extra support, some tweaks to feeding, and lots of loving patience.