Gastro-oesophageal reflux in kids and teens: GP-guide

Overview

Gastro-oesophageal reflux happens when stomach acid or food contents flow back into the oesophagus (food pipe). It’s quite prevalent among infants, and it can also affect children and teenagers. This guide will help you understand the symptoms, causes, and when to seek medical advice.

Note: The content of this blog is for informational purposes only and does not replace professional medical diagnosis, advice, or treatment.

What is gastro-oesophageal reflux (GOR)?

Reflux happens when the valve between the stomach and oesophagus relaxes, allowing stomach contents to flow back up. Think of it as a door that doesn’t close properly, allowing food to slip back up, especially after meals. This is why babies often spit up, and older children may feel heartburn. While it can occur at any age, it is particularly common among babies and usually improves with growth.

GOR vs GORD

Reflux is often mild and doesn’t cause any harm. But if it causes pain, feeding issues, slow growth, or other troubles, it’s described differently.

GOR is common and often harmless. GORD needs a GP assessment and may require treatment.

Causes

Why babies get reflux

Baby digestive systems are immature, and the valve at the top of the stomach may be weak. Hence, spitting up is common and usually improves as they grow.

Why older kids and teens get reflux

Diet, lifestyle habits and stress can lead to reflux as children get older. Common triggers include:

• Overfeeding in babies
• Food triggers (spicy, acidic foods)
• Eating large meals
• Obesity
• Stress and anxiety
• Certain medications
• Lying down soon after eating

Symptoms of reflux at different ages

Reflux symptoms vary with age. Babies can’t explain how they feel, while older children and teens can often describe sensations such as heartburn.

Babies (0–12 months)

Common symptoms include:

• Frequent spitting up
• Irritability after feeding
• Arching of the back during or after feeds
• Refusing feeds
• Poor or disrupted sleep

Reflux is quite common in babies because their digestive system is still developing. Many babies who spit up are otherwise healthy and growing well. Symptoms generally peak at around 3-4 months and improve as babies start sitting and eating solids.

Children (1–12 years)

Common symptoms include:

• Heartburn or abdominal pain
• Persistent cough
• Hoarse voice
• Nausea

In younger children, reflux symptoms are not always obvious. They might complain of a sore tummy or a persistent cough rather than feeling heartburn. If symptoms continue or start affecting daily life, it’s important to see a GP.

Teenagers

Common symptoms include:

• Burning sensation in the chest
• Sour taste
• Difficulty swallowing
• Night-time symptoms

Teen reflux is quite similar to adult reflux and is commonly associated with diet, late-night eating, stress, and lifestyle habits. Symptoms may worsen during exam periods or with too much fast food. GP assessment can help guide management and prevent long-term problems.

How GPs diagnose reflux in kids and teens

Most children don’t require tests; diagnosis is often based on history and symptoms.

Typical steps GPs take:

• Ask about symptoms
• Evaluate feeding and dietary habits
• Check growth and weight
• Do a physical examination
• Arrange tests (only if needed): pH study, endoscopy, allergy tests

Home remedies and lifestyle tips

Simple changes at home can help ease reflux symptoms in many children. These strategies are usually the first step before using medication.

This information is for educational purposes only. You should consult a GP before attempting home remedies to ensure they are safe for your specific condition.

For babies:

• Burp during and after feeding: Burping helps release trapped air, which reduces pressure on the stomach and lowers the chance of milk coming back up.
• Keep baby upright after feeding: Holding your baby upright after feeding allows gravity to help keep milk in the stomach.
• Offer smaller, more frequent feeds: Smaller feeds are easier for a baby’s stomach to handle and can reduce reflux episodes.
• Try slower-flow teats: Using slow-flow teats can help reduce overfilling of the stomach and limit spit-ups.

For kids and teens:

• Avoid late-night eating: Eating late at night increases the risk of reflux when lying down.
• Eat smaller meals: Large meals stretch the stomach and increase pressure, making reflux more likely.
• Reduce trigger foods: Spicy, fatty, and fried foods can worsen reflux symptoms.
• Encourage slower eating: Eating quickly can result in swallowing air and consuming too much food, both of which can worsen reflux.
• Maintain a healthy weight: Excess weight increases pressure on the stomach, triggering reflux symptoms.
• Elevate the head of the bed (teens only): Raising the head of the bed slightly can help reduce nighttime reflux.

Medical management options

When lifestyle changes and home care aren’t enough, the GP may consider:

• Antacids (short-term relief)
• H2 blockers
• Proton pump inhibitors (PPIs)
• Thickened feeds for babies
• Specialist referral to paediatric gastroenterologist if symptoms persist

Important: Medications, especially for babies, should only be given under GP supervision.

When to seek urgent help

If your child has any of the following, see a GP or go to the emergency department:

• Severe or persistent vomiting
• Blood in vomit
• Refusal to feed
• Poor weight gain
• Trouble breathing
• Persistent cough or choking
• Severe chest or stomach pain

If your child has any of the following, call 000 immediately or visit the nearest Emergency Department (ED).

Long-term outlook

Most babies outgrow reflux by 12–18 months. Older children and teens often feel better with simple lifestyle changes. Chronic GORD may require regular check-ups, but can be effectively managed with proper care.

How Hola Health can help

Hola Health makes it easier to get support without long waits:

• Same-day online GP consultations
• GP assessment of reflux symptoms
• Advice on feeding, diet, and lifestyle
• Prescriptions, if clinically appropriate
• Specialist referrals (paediatric gastroenterologist)
• Follow-up care via telehealth, providing a convenient option for busy families across Australia.

Note: While telehealth is convenient for advice and management, some symptoms may require a physical examination that cannot be performed online. In such cases, your online GP will advise you to see a doctor in person.

Conclusion

Dealing with reflux in kids and teens doesn’t have to be overwhelming! With the right care, thoughtful food selections, appropriate medications, and a few lifestyle adjustments, many children can improve and return to their energetic routines. It's important for parents to collaborate with healthcare providers to ensure optimal health for their child.

FAQs

Is reflux normal in babies?

Yes, it’s quite common and mostly harmless.

Can reflux cause a cough?

Yes, reflux can irritate the throat and cause a cough.

What foods make reflux worse?

Spicy, fatty, or acidic foods can trigger reflux symptoms in older kids and teens.

Is reflux the same as a food allergy?

Not really, but symptoms may overlap, especially with cow’s milk protein allergy.

When should I take my child to a GP?

If symptoms are frequent, painful, affect feeding or growth, consult a doctor.

Can stress cause reflux in teens?

Stress doesn’t directly cause reflux, but it can affect eating patterns and trigger symptoms.