Silent Reflux in Babies: Causes, Symptoms, Treatment

Posted by Kerry Nevins on

Reflux is a common problem in babies, and it usually starts in the first two months of life. More than half of babies spit up, and the majority of babies with reflux are considered ‘happy spitters’.

Reflux, in more acute cases, can cause pain in babies. Reflux is easily recognised in babies who spit up and have irritability symptoms, however some babies may not spit up at all. This is referred to as silent reflux. Other signs of gastroesophageal reflux disease (GERD) in babies with silent reflux include fussiness and poor feeding habits. Parents of babies who do not spit up, on the other hand, may confuse their babies symptoms with colic.

What Is Silent Reflux?

The contents of the stomach flow back into the larynx (voice box), back of the throat, and nasal passages in silent reflux, also known as laryngopharyngeal reflux (LPR). The term "silent" is used since the reflux is not always accompanied by visual symptoms.

What Is Silent Reflux?

Regurgitated stomach contents can go back into the stomach rather than being ejected from the mouth, making diagnosis difficult. Reflux occurs frequently in babies as young as a few weeks old. Your doctor may recommend treatment if it lasts more than a year or creates problems for your baby.


A common thread amongst many reflux babies is that they will display an unprecedented amount of crying due to their digestive discomfort and can be extremely difficult to settle. Babies with silent reflux may not spit up after feedings, making it more difficult to spot. Other symptoms of silent reflux include:

  • Irritability
  • Trouble sleeping
  • Choking
  • Gagging
  • Nasal congestion
  • Arching the back while feeding
  • Chronic coughing
  • Refusing to eat
  • Pauses in breathing (apnea)
  • Noisy breathing or wheezing
  • Hoarseness

Feeding difficulties are common in babies with reflux, which can impede weight gain or even cause weight loss. In severe circumstances, this might lead to malnutrition.

Failure to thrive (FTT) is defined as a lack of or inability to maintain growth during early life, and it can be caused by reflux.

Causes Of Reflux In Babies

One reason babies are prone to reflux is that their esophageal sphincter muscles are undeveloped when they are born. These are the muscles that allow fluid to travel through the oesophagus by opening and closing it. Because these muscles mature as new borns grow, reflux is more common in younger babies. Babies also spend a lot of time laying on their backs, especially before they learn to roll over which usually happens when your baby is between four to six months old. Lying on the back means that babies don’t have the benefit of gravity to help keep food in their stomach. However, you should always put your baby on their back to sleep to reduce the risk of suffocation. The mostly-liquid diet of babies can also contribute to reflux as liquids are easier to regurgitate than solid food.

Reflux may be more common in babies with the following conditions:

  • Neurological disorders, such as cerebral palsy
  • Prematurity
  • A family history of reflux
  • Hiatal hernia
  • Weak upper stomach valve

Treatment For Baby Reflux

Your baby's doctor will be able to tell you whether their symptoms can be controlled at home or if medical help is required. The following suggestions may help babies with reflux issues.

Smaller, More Frequent Feedings

While awake, feed your baby every 2-3 hours. This could involve cutting back on the amount of milk your baby gets at each feed. Overeating can worsen reflux symptoms by increasing abdominal pressure. Top Tip - look for bottles that are made to limit the quantity of air your baby ingests during feedings.

Smaller, More Frequent Feedings

Keeping Baby Upright During and After Feedings

Holding your baby quite upright during feedings and for 30 minutes afterward can help to alleviate reflux symptoms. Spitting up or heartburn might occur if your baby is put down to play or sleep too soon after a feed. Avoid putting your new born in a car seat or a chair, and don't let them sit in a slumped position because this can create abdominal compression. These techniques can reduce the likelihood of discomfort or regurgitation.


Burp your baby right away, as well as multiple times throughout a feed, ideally after every ounce or two. This will reduce stomach pressure and the associated discomfort. When compared to waiting until your new born has a full stomach, frequent burping is also good for reducing possible regurgitation.

Smaller, More Frequent Feedings

Tummy Time

Giving your baby tummy time each day will help aid in their digestion with the benefit of gravity to help them hold their milk in their stomach. Regular tummy time also allows your baby to strengthen their muscles and progress through their developmental milestones whilst improving their digestive system. This means that your baby will work their way towards outgrowing silent reflux.

The babocush is designed specifically with reflux babies in mind and provides that extra comfort needed for your baby. While on their tummy, the cushion helps recreate the conditions of the womb with a heartbeat simulator and gentle vibrations. The device inside every babocush cushion sends out a gentle, consistent heart beat to soothe your baby. To learn more about the babocush cushion, you can shop our collection here.

Diet Modifications

A small portion of what you eat makes its way into your breast milk. Your nursing baby is susceptible to the same foods and beverages that cause you discomfort. Caffeine, chocolate, and garlic, as well as food intolerances to proteins in dairy, soy, and eggs, are known to aggravate reflux. If you detect a pattern of fussiness after eating certain foods, try cutting them out of your diet to see if your symptoms improve. Remember that some foods, such as dairy, might take up to two weeks to leave your system.

Breastfeeding women might think about changing their breastfeeding practices as well. When milk is expelled too quickly, it can cause newborns to choke. Some mothers have a strong let-down reflex. Breast engorgement, on the other hand, can make it difficult for your baby to latch, causing more air to be swallowed. In either instance, briefly pumping before nursing can be beneficial.


There are certain medications which may help babies who choke, have breathing problems, or are diagnosed with failure to thrive as a result of their reflux. If your baby's reflux symptoms are severe and don't improve after making modifications at home, your baby's doctor may prescribe medication. For babies with reflux, medication is usually only prescribed as a last resort and should only be given under the supervision of your child's physician.


If your baby is struggling with sleep and feeding issues and is particularly irritable with prolonged frequent crying stints then they may be suffering from silent reflux. You can help to alleviate symptoms for your baby by feeding them smaller amounts of milk more frequently throughout the day. Holding your baby in an upright position for thirty minutes after feeding will aid in their digestion. During this time you should also burp your baby thoroughly to avoid any painful trapped wind. Thankfully reflux is a condition that smaller babies will eventually grow out of and daily tummy time will help them to reach those all important developmental milestones. If all else fails please do not hesitate to contact your pediatrician to see if medication is needed for your baby. 

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