All about silent reflux

With common reflux, your baby’s stomach contents flow back into the esophagus or mouth. This is also called gastroesophageal reflux. It is very common in babies and is often harmless. Your little one regularly regurgitates some food, for example when burping, when it has hiccups or while coughing. Do you want to know more about this type of reflux? Then check out our article on reflux in babies.

Hidden reflux — also known as silent or complex reflux — is when food and stomach acid flow back into the esophagus, but your baby doesn’t spit it out. Instead, he or she swallows the stomach contents again. This can cause abdominal pain and an irritated esophagus.

Silent reflux isn’t always easy to spot because your baby doesn’t spit out the regurgitated stomach contents. But there are a number of symptoms that can point to silent reflux in babies, such as:

• Sour breath
• Frequent swallowing, especially after feeding
• Crying when your baby is lying flat
• Screaming or turning red from pain
• Frequent desire to to soothe the throat
• Frequent and long spells of hiccuping
• Little or restless sleep

As with common reflux, silent reflux occurs because the sphincter between the esophagus and stomach is not yet fully developed in babies. This means that food and stomach contents can flow back easily. Usually, the sphincter muscle is fully developed around 18 months, and the complaints will diminish and disappear automatically. 

What can you do?

There are a few things you can do to alleviate your baby’s discomfort. 

• Posture: Hold your little one upright for about half an hour after feeding him or her Use a sling or a rocking chair if appropriate. 
• Feeding: Give your baby smaller amounts of food more often and consider thickening (expressed) breast milk or baby formula. Also, pause during feeding to prevent your baby from swallowing excessive air.
• Sleep: Always position your baby on its back when you put him or her to sleep. 

Would you like to find out how other parent are coping with silent reflux in their babies? Then check out the form in our app to chat with other parents and to share tips with each other.

If your baby is still experiencing severe reflux symptoms after trying the tips above, we advise that you consult your doctor. Contact your doctor right away:

• if your baby does not want to eat 
• brings up unusual stomach contents 
• has blood in its stool
• has breathing problems
• can’t stop coughing. 

In most cases, no additional testing is necessary and the doctor can make the diagnosis based on the symptoms. Adjustments in the diet often help. When symptoms are severe, medication such as antacids can be prescribed. In rare cases, further investigation or medical intervention may be required. 

Fortunately, the symptoms mostly disappear before your baby is 18 months old. Do you have any questions about silent reflux? Don’t hesitate to contact your GP for advice.