If your baby has been diagnosed with reflux, you may have been prescribed infant antacids, told to try a hypoallergenic formula, or simply reassured that they’ll grow out of it. You may have done all of these things and still have an unsettled, uncomfortable, distressed baby.
If that sounds familiar — you’re not alone, and you’re not imagining it. The problem is not your baby. The problem is that reflux is almost always treated as a diagnosis when it is actually a symptom.
Why Reflux Is So Misunderstood
Reflux — and particularly silent reflux — has become one of the most commonly diagnosed and most frequently mismanaged conditions in infancy. It is real. But the way it is typically investigated and treated overlooks some of the most significant contributing factors entirely.
In my clinical experience, the root causes of infant reflux are rarely straightforward and almost never singular. They may include:
- Functional feeding issues — how a baby latches, sucks, swallows and manages milk flow has a profound impact on how much air they swallow and how comfortably they feed. Aerophagia — air swallowing during feeding — is one of the most common and most overlooked drivers of reflux symptoms, and it is almost always rooted in function.
- Oral ties — tongue tie, lip tie and buccal ties can all affect how a baby feeds,
how much air they ingest, and how efficiently they remove milk. In some cases a baby is working so hard to coordinate breathing and feeding around a restriction that their nervous system shifts into a state of stress — which itself
affects digestion. - Gut microbiome imbalances — the health of your baby’s gut plays a significant role in how comfortably they digest milk and manage the early introduction of foods.
- Allergies and intolerances — cow’s milk protein allergy and other intolerances can contribute to reflux symptoms. However, in my experience these are frequently over-diagnosed as the sole cause when the picture is actually more complex — a combination of functional issues and dietary sensitivity that needs to be addressed together, not in isolation.
- Position and feeding dynamics — how a baby is held, how milk flows, and how feeding is managed all influence reflux symptoms in ways that are rarely discussed in a standard GP or paediatric appointment.
What I Do Differently
When I assess a baby with reflux, I take a comprehensive case history — looking at the full picture from pregnancy and birth through to the present day. I observe your baby feeding, whether at the breast or bottle, because watching what actually happens during a feed tells me things that no questionnaire or scan ever could.
GPs and paediatric gastroenterologists do not routinely observe feeding. And in my experience, even when they do, the functional aspects of how a baby feeds are rarely within their area of expertise.
I look at function, gut health, oral ties, maternal diet, feeding dynamics and nervous system regulation together — because in the most complex cases, which are increasingly the cases I see, the answer is never found in just one place.
A Note on Silent Reflux
Silent reflux — where stomach contents rise without visible spitting up, causing discomfort and distress — is a real and recognised condition. But it is also one of the most over-diagnosed labels in infant health.
A baby who arches at the breast, who seems uncomfortable during or after feeds, who is unsettled and hard to soothe — may indeed have silent reflux. But they may also be a baby who cannot organise themselves effectively for feeding, who is working too hard to keep up with milk flow, whose oral ties are creating tension and discomfort, or whose nervous system is dysregulated in a way that affects every
aspect of feeding and digestion.
The symptoms can look almost identical. The causes — and therefore the solutions — are completely different.
You Deserve a Proper Answer
If your baby has been struggling with reflux and you feel like something is being missed — it probably is. The cases I see most frequently now are the complex ones: babies who have been through the medical system, tried the medications and the formula changes, and are still suffering.
These are the cases I specialise in. And in my experience, when you look carefully enough at the whole picture, there is almost always an answer.