Infant Acid Reflux – How to Soothe Your Little One Naturally

If your baby spits up after nearly every feed, arches their back, or fusses through nursing sessions, you’re probably wondering: Is this just normal baby behavior, or is something more serious going on? You’re not alone. Infant acid reflux is one of the most common concerns new parents bring up at pediatric visits. The good news? In most cases, it’s not dangerous—and it almost always gets better with time. (NIDDK – Facts for infant acid reflux and GERD).

Let’s walk through what reflux really is, why it happens (even in breastfed babies), when to worry, and what you can do to help your little one feel more comfortable.

What Is Infant GERD and Reflux?

All babies spit up. In fact, up to 70% of infants will regurgitate milk at least once a day in their first few months. (Curien-Chotard et al, BMC Pediatrics, 2020) That’s because their digestive systems are still maturing, and the muscle that closes off the stomach (the lower esophageal sphincter) is weak. Combine an immature digestive system with lots of time lying flat and a liquid diet, and reflux is the result.

Here’s the important distinction:

• GER (Gastroesophageal Reflux): Normal spitting up or “wet burps.” Often called “happy spitters” when babies aren’t bothered by it. (HealthyChildren.org).
• GERD (Gastroesophageal Reflux Disease): When infant acid reflux causes problems—like pain, poor weight gain, feeding refusal, or breathing issues.

Most infants have GER. A much smaller number develop GERD.

Infant Acid Reflux in Breastfed Babies

Breastfed babies are often less likely to experience troublesome reflux than formula-fed babies. That’s because breast milk digests more quickly and easily, so it spends less time sitting in the stomach, where it can flow back up. Breast milk also contains natural enzymes and hormones that support gut maturity and motility, helping the digestive system move food along smoothly. In addition, breastfeeding positions typically keep babies more upright compared to bottle-feeding, which can also reduce backflow. While reflux can happen with any feeding method, breastfeeding often makes episodes shorter and less severe.

A few common factors can influence how often reflux occurs in breastfed babies:

• Immature digestive system: The main cause, regardless of how baby is fed. (Mayo Clinic)
• Fast let-down or oversupply: If milk is flowing too quickly, baby may gulp, swallow air, and overfill their tummy.
• Poor latch: Taking in extra air increases stomach pressure, which makes spitting up more likely.
• Diet sensitivities: In some cases, proteins from foods like cow’s milk or soy pass into breast milk and may irritate sensitive babies. (Lactation Network)
• Growth spurts: During these phases, babies feed more frequently and quickly, which can temporarily worsen reflux.
• Other risk factors: Prematurity, family history of reflux, or exposure to cigarette smoke can all make reflux more likely.

Common Signs of Infant Acid Reflux

Typical, Harmless Reflux Signs

• Spitting up milk (sometimes a lot!)
• Hiccups
• Burping often
• Occasional fussiness with feeds
• Cluster feeding or changes in feeding frequency
• Still gaining weight and generally content

Red flags—Talk to Your Doctor if You See These

• Poor weight gain or weight loss
• Frequent, forceful (projectile) vomiting
• Blood or green color in vomit
• Refusal to feed or obvious pain with feeding
• Chronic cough, wheezing, or trouble breathing
• Extreme irritability not soothed with normal comfort measures

Many parents think back-arching or fussing always means reflux pain. But a 2023 study found less than 10% of those episodes were actually linked to infant acid reflux. (Nationwide Children’s Hospital, 2023) Babies can arch for lots of reasons—gas, tiredness, or just being cranky.

What Is Silent Reflux?

Silent reflux is when stomach contents flow back into the esophagus but don’t come all the way out as spit-up. Because there’s no visible mess, it’s easy to miss. The reflux is still happening internally, and it can irritate the esophagus or throat.

Possible signs of silent reflux include:

• Frequent swallowing or gulping after feeds
• Persistent cough, throat clearing, or congestion
• Hoarse or raspy voice/cry
• Back-arching or neck-arching without spitting up
• Feeding struggles—pulling off, refusing, or wanting to feed constantly
• Poor sleep or frequent waking

Because these symptoms can overlap with colic, teething, or just fussiness, silent infant acid reflux is often overlooked. If you suspect it, track symptoms and discuss them with your pediatrician.

How Reflux Is Diagnosed

Most of the time, your pediatrician can diagnose reflux just by listening to your baby’s story and checking their growth. Special tests—like pH monitoring or endoscopy—are rarely needed unless there are red flags or symptoms that don’t improve with simple changes. (MedlinePlus)

Helping a Breastfed Baby with Reflux

Here are gentle, practical strategies to try:

Infant Acid Reflux Feeding Positions

Hold your baby so their head is higher than their stomach. Semi-reclined or upright positions let gravity help keep milk down. You can also try laid-back breastfeeding if your let-down is strong, so your baby has more control over the flow.

Create a Calm Environment

Feeding in a quiet, dimly lit room helps your baby stay relaxed and focused. A calm baby swallows less air, which means less pressure in their tummy and fewer reflux episodes.

Smaller, More Frequent Feeds

Instead of filling your baby’s tummy with a large feed, try offering shorter, more frequent nursing sessions. This reduces the chance of overfilling their stomach, which is one of the biggest triggers for spitting up.

Burp Regularly

Stop partway through a feed to gently burp your baby. Releasing swallowed air before it builds up lowers stomach pressure and reduces spit-up. Some babies do best with burps every 5–10 minutes of nursing.

Experiment with Latch and Let-down

If your baby is gulping or choking at the breast, you may have a fast let-down. Expressing a little milk before nursing, or feeding in a reclined position, can slow the flow and make feeding easier on your baby’s stomach.

Watch for Clothing Pressure

Tight waistbands, diapers, or carriers that press on the belly can push milk back up. Dress your baby in loose clothing and make sure their tummy isn’t restricted after feeds.

Mother’s Diet

Some babies are sensitive to proteins from foods like dairy or soy in breast milk. If your pediatrician suspects this, they may suggest a short elimination diet trial to help with infant acid reflux. Always do this with guidance so your diet stays healthy and balanced.

Babywearing

Using a sling or soft carrier keeps your baby upright after feeds while also soothing them with closeness and movement. This can make a big difference for refluxy babies who are uncomfortable lying flat.

Gentle Soothing

Skin-to-skin contact calms your baby’s nervous system, and infant massage can ease fussiness and help with digestion. While it won’t “cure” reflux, it can make your baby more comfortable overall.

For most babies, these small changes make a big difference.

When (and How) Doctors Treat Reflux

If conservative steps don’t help and your baby is really struggling, your pediatrician might discuss medications:

• Acid blockers like proton pump inhibitors (PPIs) or H2 blockers. These reduce stomach acid, but studies show they don’t always relieve infant reflux symptoms, and they can have side effects. (PMC Review, 2019)

Because of that, doctors use them cautiously and only when clearly needed. Surgery is almost never necessary.

Will My Baby Outgrow Reflux?

Yes—almost always. Reflux tends to peak around 3–4 months and then improves as babies sit up, eat solids, and their digestive muscles strengthen. By their first birthday, only about 1 in 10 babies still have symptoms.

So while the days of endless burp cloths may feel long, this stage usually passes on its own.

Resources

• Find a breastfeeding support group near you.
• Milkology Breastfeeding Class – Affordable, video-based online course to help you master breastfeeding at your own pace.

References

• NIDDK – Acid Reflux (GER & GERD) in Infants
• Curien-Chotard et al., BMC Pediatrics (2020) – Prevalence & natural history of infant reflux
• HealthyChildren.org – GER & GERD in Children (AAP)
• Mayo Clinic – Infant Acid Reflux: Symptoms & Causes
• Association of Breastfeeding Mothers (ABM) – Reflux and Breastfeeding
• Lactation Network – Reflux and Breastfeeding
• Nationwide Children’s Hospital (2023) – Study on irritability and GERD
• MedlinePlus – Reflux in Infants
• NHS Start for Life – Breastfeeding challenges: Reflux
• Seattle Children’s Hospital – Reflux (Spitting Up)
• PMC Review (2019) – Gastroesophageal reflux disease in neonates and infants