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Gastro-Oesophageal Reflux (GOR)

What is Gastro-Oesophageal Reflux (GOR)?

All babies regurgitate/posset/ vomit small amounts of milk after feeding. This is because food (from the stomach) comes up through the oesophagus (gullet) into the mouth. GOR happens because the muscles at the lower end of the oesophagus are too relaxed and allow milk to come back into the oesophagus from the stomach. About 40% (4 out of 10) of babies have Gastro-Oesophageal Reflux.

The doctors may diagnose this condition if:

  • Vomiting is particularly frequent
  • The child becomes particularly distressed during or after feeds or when vomiting.
  • Your baby is not gaining weight.

It is important to realise that GOR is not a disease. Although it is messy and upsetting, it is quite normal as your baby grows older, the muscle should open only when he or she swallows, and remain tightly closed at all other times to prevent stomach contents escaping. This is why most babies grow out of reflux by 18 months.

GOR does not mean that your child is sick. Most children grow out of it as their oesophagus and stomach develop.

What can I do to help my child?

There are steps you can take to prevent GOR.

  • Wind your baby regularly during feeds.
  • Do not over-feed your baby (ask your health visitor if you are unsure how much to feed)
  • If your baby is bottle fed, feed them upright and try using a smaller teat so that your baby gets their milk more slowly.
  • Hold your baby upright for a period after feeding.

Despite all your best efforts, some babies will continue to vomit. This is not a cause for alarm.

When should I see my GP?

If reflux happens often, or your baby is violently sick, appears to be in pain or you’re worried for any other reason, talk to your health visitor or GP – especially if they have any of the following symptoms:

  • Coughing, gagging or trouble swallowing
  • Frequent projectile vomiting
  • Persistent crying and being irritable
  • Wheezing
  • Bad breath
  • Difficulty sleeping
  • Arching their back during or after a feed
  • Drawing their legs up to their tummy after feeding
  • Refusing a feed even though they're happy to suck on a dummy or similar
  • Not gaining much weight, or losing weight.

An allergy 

If you think your baby is having a reaction to infant formula or cows' milk, tell your GP. Some of the signs are a skin rash, vomiting and diarrhoea.

Your GP can prescribe special formula feeds called "extensively hydrolysed protein feeds" (see When should I see my GP?).

If your baby is allergic to cows' milk, eliminating it from their diet for two to three weeks should reduce their vomiting considerably. If you breastfeed, you'll need to exclude cows' milk from your own diet.

Some infant formula is labelled as hypoallergenic, but this is not suitable for babies with a diagnosed cows' milk allergy.

Always talk to your GP before using hypoallergenic or soya-based infant formula, as babies who are allergic to cow's milk may also be allergic to soya.

If your baby continues to vomit despite cutting out cows' milk, it's unlikely that an allergy is the problem.

Does my baby need any tests?

Usually, the doctor is able to diagnose GOR from the information you give. If the doctor is in any doubt about the diagnosis, they may recommend tests, but this is not usually necessary.

If your baby is diagnosed with GOR, your health visitor will make sure that they are gaining weight at their routine checks. If they have any concerns, they will tell you. It is not usually necessary for you to keep coming back to hospital for follow-up appointments, unless your health visitor or GP are concerned.

Are there any long term complications?

Most children with GOR grow out of it within the first six months, and it is unusual for them to still have problems after their first birthday. As long as your child is gaining weight, it is extremely unlikely that they will come to any harm from GOR.

Where can I get more information?

Your health visitor will be able to give you support, and answer your questions.

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