My Baby Has Reflux

Definitions

Gastro-Oesphageal Reflux (GOR) is the effortless regurgitation or spitting up of gastric (stomach) contents into the oesophagus (food pipe) with or without effortless regurgitation and vomiting

Gastro-Oesphageal Reflux Disease (GORD) occurs when the reflux of gastric (stomach) contents causes troublesome signs and/or complications, that is, when GOR has an adverse effect on the well being of the baby, for example, when the GOR causes poor weight gain or complications such as oesophagitis or respiratory signs. This requires medical assessment before a diagnosis of GORD is made

Regurgitation in children is defined as the passage of refluxed contents into the throat, mouth or from the mouth. Other terms include “spitting up”, “possiting” or “spilling’. It is a characteristic sign of reflux in infants but is not diagnostic of GORD.

Red Nose recommend that all babies, including those with GOR, sleep on the back on a firm, clean and well-fitting mattress that is flat (not tilted or elevated) to reduce the risk of SUDI.

• Regurgitation in infants is normal for up to 50% of babies less than three months of age and 70% of completely healthy infants under twelve months of age. Most of this regurgitation resolves spontaneously after 6 months, and completely by twelve months in 95% of babies.
• Babies with GOR should be placed to sleep on their back from birth on a firm, flat mattress that is not elevated.
• Elevating the sleeping surface for back sleeping babies does not reduce GOR and is not recommended.
• If a baby is in a tilted cot, further hazards may be introduced into the sleeping environment. When tilted, babies are more likely to slip down the cot and become completely covered by bedding, or if a pillow is used to elevate the baby, pillows become a suffocation hazard.
• In babies with GOR, the risk of sudden death when baby is in the tummy or side sleeping positions outweighs any benefits of tummy or left side positioning of babies.
• If, for a rare medical reason a baby must be slept in a position other than the back position, medical staff should advise the parents in writing and provide information about the other ways parents can use to reduce the risk of SUDI.
• Medical assessment is required for a diagnosis of Gastro-Oesphageal Reflux Disease (GORD).