How is reflux in babies different in infants?

Milk may come back up during or soon after a feed, sometimes with brief fussiness or hiccups. Many babies remain comfortable, feed well and continue to grow. Reflux becomes more concerning when it causes repeated distress, arching, choking, refusal of feeds, persistent cough or poor weight gain. Vomiting that is forceful, green or bloody is different from ordinary spit-up and should be assessed.

Offer feeds in the way advised for your baby and pause for burping when needed. Keep the baby upright while awake after feeding, with an adult watching. Always place the baby flat on their back for sleep; do not use pillows, wedges or inclined sleep products. Do not thicken feeds, change formula or give reflux medicines without a clinician's advice, because the right approach depends on feeding and growth.

Contact a clinician if the baby is not feeding well, has fewer wet nappies, is not gaining weight, seems persistently distressed or has repeated coughing or choking with feeds. Seek urgent care for breathing difficulty, blue or grey colour, unusual sleepiness, green or bloody vomit, a swollen abdomen or signs of dehydration.

Is this spit-up consistent with uncomplicated reflux? Could feeding technique, allergy or another problem be contributing? How should we monitor wet nappies, feeds and growth?