Milk everywhere: what I wish I had known about baby reflux

Three muslins on each shoulder, a permanent milky smell on every top, and a nagging question after every feed: is this normal, or is something wrong? If your baby brings up milk a lot, you are far from alone. Here are the things many parents say they wish someone had told them sooner.

1. Some spit-up is completely normal

Reflux simply means milk coming back up from the stomach into the food pipe or mouth. It is very common in babies because the ring of muscle at the top of the stomach is still developing and their diet is all liquid. Many babies bring up small amounts after feeds, or do a wet burp, and are otherwise content and growing well. Reflux often starts in the first weeks and usually improves as babies grow, sit up more and start solid food; for most, it settles by around their first birthday.

2. It often looks like more milk than it is

A small amount of milk spread across a muslin or your shoulder can look alarming. What matters more is whether your baby is feeding, making plenty of wet nappies and gaining weight as expected at their checks. If those are all fine, a messy baby is usually a healthy baby.

3. Small changes can help

• Feed in a more upright position, with your baby's head higher than their tummy.
• Hold them upright for a while after feeds, rather than lying them straight down or bouncing them.
• Wind them during and after feeds. A pause halfway through can help.
• Avoid tight waistbands and nappies done up too firmly around the tummy.
• If bottle-feeding, check the teat flow is right and ask your health visitor whether smaller, more frequent feeds could help. Do not change formula or thicken feeds without talking to a professional first.
• If breastfeeding, a midwife, health visitor or breastfeeding supporter can check positioning and attachment, which can make a difference.

4. Safe sleep does not change

It can be tempting to raise the cot or lay a baby on their side or tummy because you worry they might choke. Please do not. Always lay your baby on their back to sleep on a firm, flat mattress, with no wedges, pillows or positioners. Healthy babies have natural reflexes that protect their airway, and back sleeping is the safest position for babies with reflux too, unless a doctor has specifically advised otherwise for your baby.

5. There are signs that need checking

Speak to your health visitor or doctor if your baby:

• Is not gaining weight, or is losing weight.
• Regularly refuses feeds, arches their back or seems in pain while feeding.
• Coughs, gags or chokes a lot during feeds.
• Has reflux that starts after about 6 months, or carries on well past their first birthday.
• Has frequent chest infections or ongoing diarrhoea.

Get urgent medical help if your baby:

• Vomits forcefully, with milk shooting out, especially after every feed.
• Brings up green or yellow-green vomit, or vomit with blood in it.
• Has blood in their poo.
• Has a swollen, hard tummy.
• Has a high temperature, is floppy or very drowsy, or shows signs of dehydration such as far fewer wet nappies.
• Has difficulty breathing.

6. Your feelings count too

Constant spit-up, endless laundry and a baby who seems uncomfortable can wear you down. It can feel personal, as if your feeding is the problem. It is not. Reflux is about a baby's developing body, not a parent's failure. If you feel tearful, anxious or overwhelmed most days, tell your health visitor or doctor. Accept offers of help with the washing. Keep a spare top in the changing bag for yourself, not just for the baby.

7. You can hand over the worry

Peter wrote, “Casting all your care upon him; for he careth for you” (1 Peter 5:7). All your care, including the anxious checking of every muslin and the worried look at every weight chart. God is not tired of hearing about it. You can name each worry to Him, take the practical next step, and let Him carry what you cannot.

A prayer after a messy feed

Father, I cast this care on You: my baby's tummy, their feeding and their growth. Settle their little body and help them thrive. Give me patience with the mess and peace in my heart, because You care for us both. Amen.