Reflux in babies - what's normal & what might be worth investigating
If your baby is spitting up constantly, arching their back, or seems unsettled after feeds, reflux is likely the first thing you've been told about. And possibly the last - with reassurance that they'll grow out of it.
For many babies, that's true. But for some, reflux is a signal worth looking at more carefully - particularly when it's persistent, distressing, or not responding to standard advice. And increasingly, what's happening in the baby's gut also reflects what's happening in the mother's.
adapting to the outside world
At birth and during the fourth trimester, babies are doing an enormous amount of adjusting. They have an immature gut, a tiny stomach, and a need to feed frequently. Their nervous system is still learning to regulate. All of this sets the stage for digestive sensitivity that can look alarming but is often part of normal development.
They also need a great deal of touch, responsiveness to their cues, and a sense of safety - all of which directly influence gut function through the gut-brain axis, even at this early age.
reflux – common & usually normal
For most babies, reflux is both common and expected. Research suggests 60-85% of babies experience it in the first two months. The majority grow out of it without treatment, usually between 4-6 months as the lower oesophageal sphincter matures and feeds become less frequent.
This type - gastro-oesophageal reflux (GOR) - is a normal physiological process, not a disease.
when does it become GORD?
GORD - gastro-oesophageal reflux disease - is defined as ongoing reflux causing troublesome symptoms such as oesophageal irritation, breathing issues, or allergic responses. It does occur in infants, but according to research, rarely.
Importantly, international guidelines state that there is no symptom or cluster of symptoms that can definitively diagnose GORD, or reliably predict response to treatment. This matters when acid-suppressing medications are being considered.
the problem with acid-suppressing medications in infants
This is where the research becomes particularly relevant for parents navigating these decisions.
Systematic reviews have found a poor relationship between reflux symptoms, endoscopy findings, and pH levels in infants. Acid-suppressing medications have shown no better results than placebo in GORD-diagnosed babies.
More concerning is that these medications carry genuine risks in infants, including
Increased susceptibility to gut & lung infections
Higher risk of childhood fractures
Potential for increased food allergies
Reduced nutrient absorption
Disruption to the microbiome during a critical developmental window - the first two years of life, when the gut ecosystem is being established
what's actually driving the reflux?
Once true GORD has been ruled out, it's worth looking at several layers
Feeding mechanics – a lactation consultant can identify latch issues, oversupply, or flow problems that contribute significantly to reflux. Simple but powerful.
The stress-crying cycle – babies can become caught in a loop of discomfort, crying, and further gut tension. Certain herbs are safe for both mother and baby - chamomilla being a well-known example.
The mother's gut & diet (for breastfed babies) – this is an area that doesn't receive nearly enough attention. What the mother eats and the state of her own microbiome directly influences breast milk composition and the microbial signals her baby receives.
Common dietary triggers worth exploring include
Dairy (the most common, and often most impactful)
Soy, peanuts, eggs, wheat & gluten
Onion, brassica vegetables, and legumes
Eliminating suspected triggers for a trial period ideally 2-4 weeks - can be revealing.
the mother's microbiome
Gut dysbiosis in the mother affects the SCFAs (short-chain fatty acids) passed through breast milk, which are essential for gut sealing and infant gut health. Supporting the mother's microbiome with adequate fibre and anti-inflammatory omega-3s benefits the baby directly.
probiotics
For breastfed babies, specific strains have shown benefit. Not all probiotics transfer through breast milk, and giving them directly to newborns requires care and guidance. For bottle-fed babies, Lactobacillus rhamnosus GG (LGG) added to formula has demonstrated good results in research.
the mother-baby gut connection – a bigger picture
Something that becomes clear when working with families is how often a baby's gut struggles reflect unresolved gut issues in the mother. The microbiome a baby inherits at birth is seeded largely from the mother - through the birth canal, skin contact, and breast milk. When a mother has dysbiosis, food sensitivities, or intestinal permeability, this can shape the infant gut environment in ways that contribute to reflux, colic, eczema, and later food reactions.
This doesn't mean the mother has done anything wrong. It means that supporting the mother's gut health is often the most effective way to support the baby's.
Many mothers who come seeking help for their baby's symptoms discover that their own gut health - something they may have been managing for years without resolution - is part of the same picture.
when to look further
Consider a more thorough investigation if
Reflux persists well beyond 6 months with no improvement
Weight gain is affected
Symptoms include blood in stool, significant feeding refusal, or respiratory symptoms
The baby has eczema, skin reactions, or early signs of food sensitivity alongside reflux
The mother has her own history of gut issues, food sensitivities, autoimmunity, or hormonal imbalances
These patterns together often point to something worth investigating more carefully – in both mother and baby.
a note on my current practice
My work now focuses primarily on women with complex, unresolved health issues - gut dysfunction, hormonal imbalances, autoimmunity, mould illness, histamine intolerance, and chronic symptoms that haven't responded to conventional or alternative approaches.
I do still work with mothers and children, particularly where the mother's own health is part of the picture. If your baby's gut struggles have led you to look more closely at your own health - and you've found yourself wondering whether something deeper has been missed - that's often where the most meaningful work begins.
A free Chronic Symptom Review is available here if that resonates.
Nore Hoogstad is a Functional Nutritionist & Psych-K Practitioner based on the Sunshine Coast, working with clients across Australia and internationally.