When reflux is affecting your baby’s sleep, nights can feel long and difficult for everyone. Reflux can make settling and staying asleep hard for babies, and it often leaves parents unsure how to help without making things worse.
This article explains how reflux impacts baby sleep and shares gentle, practical ways to support more comfortable, restful sleep — even while reflux is still present.

When it comes to reflux and baby sleep, it’s common to feel stuck in a cycle of discomfort and disruption. Managing sleep for babies with reflux can be challenging but there are  ways to make it easier

What is reflux?

Reflux is when the contents of a baby’s stomach leak back into their oesophagus (food pipe or gullet) and cause possetting (bringing up small amounts of milk), vomiting and/or burning pain (heartburn) due to the acidity in the stomach. 

Some babies with reflux don’t vomit or posset and this is called “silent reflux.” 

Diagnosis can sometimes be difficult, as reflux is easily confused with colic.

What we call ‘reflux’ is actually ‘gastro-oesophageal reflux’ [GORD or GERD in America.]  

Reflux is most common in the first 6-12 months. 

Why does reflux happen?

The valve between the oesophagus and the stomach is called the lower, oesphageal sphincter. It sometimes doesn’t work very well when babies are little. This allows milk mixed with stomach acid to slosh backwards, especially when babies are lying flat. With maturity, this valve becomes more efficient. Usually, reflux gets better after about 6 months. Sometimes, but rarely, it can take a year or a little longer.

Reflux symptoms

• • Vomiting or possetting [although in “silent” reflux this might not happen.]

• • Crying, especially when they are lying flat.

• • Coughing.
  • Hiccuping.

• • Swallowing & gulping.
  • Arching their backs.
  • Turning away from feeds.

• • Their vomit and/or breath can smell a little bit sour and acidic because of the acidity in their stomach.

• • Poor weight gain because of not keeping their feeds down.

Reflux & cows milk protein allergy [CMPA]

Sometimes reflux is caused by a CMPA [cows milk protein allergy.] This isn’t the case for every baby who has reflux, however. Equally, not all babies who have CMPA have reflux!

CMPA has other symptoms such as skin rashes,  blood in their poo, constipation and poor weight gain.

If a baby has a milk allergy, you may be advised to cut dairy from your diet if you are breastfeeding, or if you are formula feeding, your baby may be prescribed a special non-dairy feed.

They might also be prescribed medicine to limit their stomach acid production or to neutralise their stomach acid.

Some reflux medicines can cause constipation so you will have to make sure to give them plenty of fluids and if they are taking solids, fibre in the form of fruit & vegetables.

Reflux and sleep

Babies who have had reflux [or colic] in the early weeks, whether simple “mechanical” reflux or caused by CMPA often develop sleep problems.

Babies with reflux often develop sleep difficulties because they’ve needed extra holding and comforting to settle — and haven’t yet learned how to fall asleep in other ways. That need for comfort is completely understandable — but over time, it can make it harder for them to link sleep with feeling safe and settled on their own.

Reflux sleep tips

• • Breast feed if you can, as breast milk is more digestible.
  • If you’re formula feeding, don’t try to push them to take more milk than they want.
  • Talk to your health visitor or GP about ‘comfort’ formula milk. [This isn’t suitable for CMPA.]
  • Feed little and often rather than overloading them with too much milk.
  • Hold your baby upright for around 30 minutes after feeds.
  • If they need to be held all the time, get a comfortable baby carrier to make this easier.  

• • After the first few weeks, try to separate feeding from sleeping.

• • Elevate the top of the cot, so that it slopes down at the foot, and place younger babies with their feet at the foot of the cot.

• • Give any prescribed medication in good time for it to work before bedtime.

• • When they are over 3 or 4 months, support them to fall asleep aware that they are in their sleep space. See my guidance on bedtime routines.

Bedtime routine

• • Give their milk about half an hour before bath time and hold them upright. Then by the time they go to bed, the milk should no longer be sitting heavily in their stomach.

• • Follow a familiar and predictable routine, to help them feel safe and secure.

• • Encourage them to settle to sleep aware that they are in the cot, with as little assistance as possible from you. 

• • Follow the principles of good sleeping generally, with a familiar and well-timed routine.

Night feeds

• • After any night feeds, burp your baby well and hold them upright before placing them back into their cot.
  • Older babies who are over about 7 kg in weight, don’t need a tummy full of milk to see them through the night, so long as they are generally well-fed and hydrated during the day.
  • Drop night feeds as soon as possible, so that they are not struggling to digest unnecessary feeds when they are lying down during the night.

• • •  

  For many babies with reflux, the only way they can settle to sleep is on a parent’s chest. If that’s what’s happening in your home right now, you’re not alone — and things will improve. In the meantime, be sure to follow the safe co-sleeping guidelines from The Lullaby Trust to keep you and your baby as safe and supported as possible.

Most importantly, don’t hesitate to ask for — and accept — help from family and friends. Caring for a baby with reflux is uniquely challenging, and it’s completely okay to need more support than other parents might.

Further help

If you’re struggling with reflux or any sleep issues, I am here to help you.

My books

My bestselling books give you the tools to help your baby and yourself get a good night’s sleep. They are full of expert, practical advice and case studies. Each book teaches you to create your baby or child’s personal sleep plan and is written in a clear and accessible style.

They are available in all formats from Amazon and other booksellers.

My Sleep Plans

My plans are a mix of video, graphics and easy-to-read text. They are a great way to access my expert help – from your phone, tablet or laptop. The courses have no expiry date and are updated frequently. The Settled sleep plan is very comprehensive, easy to dip in and out of and is very empowering.

The Settled Mornings plan is concise and accessible – it takes around an hour to complete and it may be the best hour you’ve ever spent!

Both of the plans contain helpful schedules for day and night time sleep.

 

Private Consultations

If you choose to book a one-to-one consultation with me, you will receive my expert advice along with an individual sleep plan for your child. You will be in very safe, experienced hands and I treat every parent and child with kindness. As a qualified health professional, I can help families with medical and developmental issues. My success rate is outstanding, with over 15,000 face-to-face sleep consultations with families from all over the world.

See my reviews on Trustpilot