Is colic in babies actually reflux?

Gastroesophageal reflux occurs when the valve between the oesophagus and the stomach doesn’t close properly, allowing stomach acid to flow back up. In adults, we call this heartburn. In babies, it produces regurgitation, burning discomfort, fussy feeding, constant agitation and disturbed sleep — everything parents describe when they say their baby has colic.

But what about the painful cramping episodes themselves — the screaming, the legs pulled up, the inconsolable distress? These too, in most cases, are caused by reflux. Every time a baby regurgitates, they swallow air along with the returning milk. This air accumulates in the intestine and travels downwards until it reaches the colon, where it creates painful spasms. That is what “colic” is. Not a mysterious separate condition — a mechanical consequence of reflux.

Reduce the reflux, and you reduce the colic. And the most effective way to reduce reflux — immediately, without medication — is to keep the baby upright.

Why keeping your baby upright helps reflux in babies

When a baby is lying flat, the stomach empties in every direction — including upwards into the oesophagus. When the baby is upright, gravity does the work: the stomach empties downwards, into the intestine, as it should. Less acid reaches the oesophagus. Less regurgitation occurs. Less air is swallowed. The cycle is interrupted.

Parents discover this instinctively — the baby placed on the shoulder calms almost immediately. They are not imagining it. The physics are real, and the effect is significant: the more time a baby with reflux spends in a genuinely upright, vertical position, the less oesophageal inflammation develops, and the less medication the baby will ultimately need.

How to alleviate reflux in babies naturally

• Use a baby carrier or sling throughout the day from the earliest weeks. This keeps the baby vertical against your body, your hands are free, and the benefits for a reflux baby are considerable. The longer the baby is carried upright, the better.
• After every feed, keep your baby upright against your chest for at least 20–30 minutes before attempting to lay them down.
• For the times when you cannot hold your baby continuously — during sleep, or when you simply need to put them down — a purpose-designed positioning device is invaluable. This is the thinking behind BabyUp®  — a solution specifically designed to help alleviate reflux in babies by keeping them safely in an upright position, which I developed after decades of watching exhausted parents hold their babies on their shoulders day and night. BabyUp® holds the baby safely in a supported upright position just like your shoulders, rocks gently, and can play a lullaby or a parent’s voice to help the baby settle. The parents who tested it did not want to give it back.

Wondering if your baby’s symptoms could be linked to reflux?

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Other things that help

Breastfeed for as long as possible. Breast milk requires less acid to digest, empties from the stomach more quickly, and causes far less oesophageal inflammation when it does reflux. Formula-fed babies tend to suffer more intensely, sooner.

If using formula, thicken it. Thickened milk stays in the stomach more readily and refluxes less. Use an anti-reflux formula, or thicken standard formula at home with unsweetened rice flour or maize starch (one scoop per 30 ml). Use a Y-cut or star-cut teat.

If your baby is in significant discomfort, speak to your paediatrician about antacid medication. Antacids based on aluminium and magnesium hydroxide, given before feeds, neutralise stomach acid safely and effectively. In more severe cases, a proton pump inhibitor may need to be added. These measures, combined with consistent postural management, make an enormous difference.

A word to exhausted parents

My own daughter Marta had reflux. I watched her face carry the expression of someone resigned to feeling ill. My wife and I were exhausted — and I was a paediatrician who, for a long time, did not know how to help my own child.

There is a reason your baby is suffering, and there is something you can do about it. Pick them up. Hold them upright against your chest. That instinct you have had all along is exactly right.