What You Need to Know: Infant Reflux

Category: Newborns

Is your baby spitting up his milk often during or after his feeds? MH gives you the lowdown on infant reflux.




Seeing your baby spitting his milk back up can be a cause of concern for parents. You might wonder if there is something wrong with your baby internally, or if he is getting enough to eat. But aside from dealing with the mess of your milk-stained clothes, your baby spitting up his milk – also known as reflux – is usually not something to be worried about.


What is Reflux?


Reflux occurs when the milk your baby has swallowed naturally flows back up through his oesophagus to his mouth, causing him to spit up his milk. This should not be confused with vomiting, where the muscles will forcefully contract to expel the stomach contents. 


What Causes Reflux?


There are several reasons why your baby has reflux, one of which is due to your baby’s still-developing digestive system. “In babies, [reflux] is usually a result of immature muscle tone around the junction of the oesophagus and the stomach, thus allowing the stomach contents to return to the mouth,” says paediatrician, Dr Low Kah Tzay, Mount Elizabeth Hospital.



Since this muscle tone is not fully developed yet,

the milk your baby eats is sometimes unable to enter his stomach,

causing the milk to come back up his mouth. As your baby grows older

and this muscle tone develops and strengthens, his reflux will subside.



Overfeeding can also cause your baby to have reflux. Remember, your baby’s stomach is still really tiny so he will not be able to handle much food at once. Feeding him when his stomach is already full will cause the milk to travel back up to his mouth, causing him to spit the milk up.


To give you a clearer picture of how small your baby’s stomach actually is, on day one, your baby’s stomach is just the size of a cherry. By day three, it will grow into the size of a walnut. By the first week, his stomach will be the size of an apricot, and it will grow into the size of a large egg by the time your baby is a month old.


Symptoms to Look Out For


Besides spitting up his milk during or after feeds – which may happen a few times a day – there are other symptoms that might indicate your baby has reflux.


Dr Low advises looking out for the following symptoms:


·         Excessive crying

·         Arching of back

·         Coughing or choking

·         Refusing to feed (if reflux is severe)


Silent Reflux


There are times when your baby might not spit up the milk that has travelled back up from his stomach. In some cases, he might swallow the regurgitated milk instead of spitting it up, or the milk might not even travel back up to your baby’s mouth completely. Both these instances are known as silent reflux.



Silent reflux can be harder to diagnose since your baby is not actually spitting up any milk.

One symptom you can still expect, though, is lots of crying because the acid 

from your baby’s stomach will regurgitate along with the milk, 

and swallowing the combination of acid and milk can be

painful and extremely uncomfortable for your baby.



Your baby might also have silent reflux if you notice him swallowing after a feed, even though you know there should not be any milk left in his mouth. Swallowing the regurgitated milk and acid might also make your baby’s throat sore, so watch out for a hoarse voice and coughing from your baby that might indicate he has silent reflux.

Thanks for sharing!