Silent reflux in babies: causes, symptoms, and treatment
What's the difference between silent reflux and reflux? And how can you tell if your baby has reflux? We have the latest advice from our expert family GP about how to spot silent reflux and how to help ease the symptoms for your baby.
Nearly all babies bring up milk or are sick from time to time, and wearing a muslin over your shoulder is practically a rite of passage for a parent.
Vomiting after a feed is so common in newborn and young babies because often the valve at the end of the food pipe (the oesophagus) hasn't fully matured yet and will strengthen as the baby grows.
But when is a bit of baby sick the sign of something more? And how do you tell if your baby is suffering from silent reflux?
For some parents, it could be as obvious as your breastfed or bottle-fed baby being sick after every feed. For others, though, the symptoms of silent reflux in their baby are less directly related to feeding, being unsettled, crying lots and failing to gain weight.
It can be worrying when your baby keeps being sick or seems constantly uncomfortable, but the good news is that reflux usually eases over time as your baby matures and should eventually stop, especially as you start to introduce solids.
In the meantime, NHS GP Dr Philippa Kaye has shared everything you need to know about silent reflux in babies, including what exactly it is, the main symptoms to look out for, how to treat silent reflux and when to seek medical advice.
What is silent reflux?
Reflux is a condition where babies are sick, bringing up milk shortly after feeding.
Possetting, or bringing up a very small amount of milk, a mouthful or two, is normal; in reflux, much more milk and vomit are brought back up. Other symptoms include burping and swallowing or gulping a lot during or after feeding, or hiccoughing or even coughing during feeding.
Babies may be unsettled and cry during and after feeding. If reflux is severe, then they may not gain weight as expected, as they are bringing up their milk as opposed to keeping it down for energy and growth. In silent reflux, the baby swallows the milk/vomit they are bringing up but may have the other symptoms of reflux.
What causes silent reflux?
All reflux, silent or not, is thought to be due to the sphincter at the bottom of the oesophagus being immature and not fully developed, allowing the milk to come back up out of the stomach. As the oesophagus matures, symptoms improve, generally by the age of one.
What can I do to prevent or reduce silent reflux?
To help your baby if they have silent reflux, try and hold them upright during feeding, or position them more upright during breastfeeding and then keep them upright as long as you can after feeds. Stopping to burp your baby regularly during feeds, be they breast or bottle, can be helpful, as can giving smaller, more regular bottles if they are breastfed.
Do not put anything in the cot/moses basket to lift the head, and ensure that your baby is always put to sleep on their back.
If your baby is not gaining weight, then your doctor may prescribe treatments, which may include a powder which thickens milk or a thicker formula milk to try to help keep it in your baby’s stomach. This is more difficult if your baby is breastfed as it would involve expressing the milk, adding the thickener and then feeding it to your baby, though some parents will choose this option.
However, if the thicker milk doesn’t help, or if you are breastfeeding, then there are medications that can be used which stop the production of acid in the stomach. Rarely, other treatments such as surgery are needed.
How long does it take for silent reflux to resolve?
Most cases of both reflux, again whether silent or not, tend to start before about eight weeks of age and tend to resolve by about the age of one. However, many parents notice that things improve much earlier, often when their child starts eating solid food.
When should you seek medical advice?
If you have concerns about your child, please seek medical advice. There is no one particular sign or symptom that you need to wait for – if you are concerned, get checked. In particular, if you are concerned about your child not gaining weight and growing, see your doctor. If reflux starts after six months old, or if symptoms don’t improve after the age of one, please see your doctor.
If you think your child has signs of dehydration, for example, they stop urinating, or become more floppy and unwell, seek urgent medical help. But if your child seems happy and is gaining weight, growing and developing as normal, then you may not need to see the doctor!
Pics: Getty Images
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Authors
Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice.