Reflux & Regurgitation
Gastro - oesophageal reflux (GOR) is an involuntary passage of gastric content from the stomach into the oesophagus, commonly seen during or shortly after feeding.1 When the reflux is high enough to be seen it is known as regurgitation.2 It is primarily due to the immaturity of the lower oesophageal sphincter.3 Infant regurgitation is categorised as a paediatric Disorder of Gut-Brain Interaction (DGBI).3 It differs from vomiting which is characterised by forceful expelling of gastric contents.2
Reflux or regurgitation can occur daily in about 50% of infants under 3 months of age4. Although it is a normal physiological process in otherwise healthy infants5 and common in the first year of life6, it can cause significant parental worry and anxiety.7
Reflux usually resolves in 90% of affected infants before 1 year of age.5
Although infant reflux is part of the range of expected behaviours in healthy infants,2 the NHS continues to experience a high number of parents seeking help from their healthcare professional.
The cost of infant reflux to the NHS is significant but certain changes in practice may help reduce this cost.8,9
For breast-fed infants NICE recommends they are referred for a breastfeeding assessment with a trained individual. If there is no improvement, then an alginate could be trialled for 2 weeks.5
For formula-fed infants, a stepped-care approach is recommended, starting with parental reassurance and support. If after practical feeding advice is given, there is no improvement, then a nutrition before medication approach is recommended with a trial of a thickened anti-reflux formula5.
- Reflux in babies, NHS 2025. Available at www.nhs.uk/conditions/reflux-in-babies/ (Accessed July 2025).
- ROME foundation. Disorders of Gut Brain Interaction-Definitions. Available at https://theromefoundation.org/disorders-of-gut-brain-interaction-definitions/ (Accessed July 2025).
- Fonkalsrud EW. and Ament ME. Gastroesophageal reflux in childhood. Curr Probl Surg 1996; 33: 1-70.
- Vandenplas Y et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of NASPGHAN and ESPGHAN. JPGN 2009; 49: 498-547.
- NICE (2015) Gastro-oesophageal reflux disease in children and young people. Available at https://www.nice.org.uk/guidance/ng1. Accessed: July 2025
- Van Tilburg MA et al. Prevalence of Functional Gastrointestinal Disorders in Infants and Toddlers. J Pediatr 2015; 166: 684-689
- Nestle Nutrition Institute (NNI) (2020). Quality of life of infants with functional gastrointestinal disorders. Available at www.nestlenutrition-institute.org/the-nest-46-functional-gastrointestinal-disorders-in-infants/quality-of-life-of-infants-with-functional-gastrointestinal-disorders (Accessed July 2025).
- NHS data provided by Inspiremed. UK prescription for Gaviscon Infant July 2023 to June 2024. October 2024.
- Leung A and Hon K. Gastroesophageal reflux in children: an updated review. Drugs in Context. 2019 17;8:212591.