What causes hiccups in a newborn?

A newborn’s diaphragm and feeding coordination are still developing. Hiccups may follow fast feeding, taking in air, overfeeding or a sudden change in stomach fullness. Mild reflux can also irritate the upper digestive tract and diaphragm; acid reflux is common in babies, although hiccups alone do not confirm it. Gastritis is a less typical explanation and should not be assumed from hiccups.

Brief episodes usually stop on their own and do not distress the baby. Notice whether they occur after every feed, with spit-up, coughing, arching, poor settling or difficulty gaining weight. That pattern gives a clinician more useful information than the sound of the hiccups alone.

Feed when the baby is calm, keep the baby fairly upright during and after feeds, and pause for burping if the baby is taking in air. Avoid forcing extra milk, startling the baby, holding the breath, giving water, or using home remedies. Do not start acid reflux medication unless a clinician has assessed the baby and prescribed or advised it.

Seek urgent help if hiccups occur with blue or grey colour, breathing difficulty, choking, unusual sleepiness, repeated vomiting, fever in a young infant, or inability to feed. Contact the baby’s clinician if episodes are frequent and prolonged, disturb sleep or feeding, or come with painful-looking feeds, poor wet nappies or poor weight gain. These features need assessment rather than home treatment.

Ask whether feeding technique, reflux or another problem could explain the pattern. Bring details about feed size and timing, spit-up, breathing, wet nappies and growth, and ask before considering acid reflux medication.