Reflux is one of the most common concerns among parents of young babies. Whether it shows up as spit-up, back-arching, fussiness, or sleep challenges, reflux can be frustrating, confusing, and downright exhausting. Some babies may be labeled with gastroesophageal reflux (GER), while others receive a diagnosis of gastroesophageal reflux disease (GERD)—a more persistent form that may include complications like poor weight gain or pain with feeding.
At Legendairy Milk, we’re all about uncovering the why. While some reflux is expected in young infants due to immature digestion, frequent or uncomfortable symptoms deserve a closer look. This blog explores possible contributing factors to reflux and how families can work with their healthcare providers to support digestive comfort—without jumping straight to medication.
1. Why Positioning Matters: Upright and Chest-to-Chest
One of the simplest adjustments that may help reduce reflux symptoms is feeding in an upright, tummy-to-tummy position. Chest-to-chest positioning helps align baby’s digestive system naturally and supports their ability to regulate swallowing and breathing. Laid-back nursing or a koala hold often encourages a deeper latch and may reduce the amount of air swallowed during feeds (1).
Even after feeding, keeping baby upright against your chest for 20–30 minutes can support digestion and reduce reflux episodes. Studies show that while upright positioning may not decrease the number of reflux events, it can reduce associated respiratory symptoms and discomfort (2).
2. Tummy Time: More Than Just Motor Milestones
Tummy time helps strengthen the core and neck muscles your baby will eventually use for crawling, sitting, and standing. But it can also support digestion. Gravity, gentle pressure on the belly, and improved muscle tone may help reduce reflux episodes by promoting gastric motility (3). Always wait 20–30 minutes after a feed to try tummy time to avoid spit-up, and start slowly with just a few minutes at a time.
3. Could It Be a Cow's Milk Protein Sensitivity?
Reflux is sometimes triggered or worsened by cow's milk protein intolerance (CMPI). In breastfed infants, this can occur when cow’s milk proteins from the maternal diet are passed into breast milk. Symptoms of CMPI may include excessive spitting up, blood or mucus in the stool, skin rashes, congestion, or colic-like crying. In one clinical study, nearly 42% of infants with reflux symptoms responded positively to the removal of cow's milk from their diets (4).
For parents working with a healthcare provider or IBCLC, a 2–4 week trial of dairy elimination may help clarify if cow's milk protein is contributing. It’s important to ensure any elimination diet is temporary and nutritionally adequate—especially for lactating parents.
4. When Elimination Diets Go Too Far
While removing common allergens like soy, eggs, or wheat may seem like a logical next step, unnecessary food restrictions can place a burden on the breastfeeding parent and limit essential nutrients. If a dietary elimination is recommended, it should be guided by a registered dietitian or an experienced lactation professional.
We also often see fenugreek—a common herbal galactagogue—coincide with reflux flares in some babies. While evidence is mostly anecdotal, it's worth considering a break from fenugreek if reflux symptoms worsen after starting a lactation supplement containing it (5).
5. Skip the Inclined Sleep Products—Stick with Safety
Parents are sometimes advised to use inclined sleepers or propped positions to manage reflux. However, these devices—like the Rock ’n Play and similar loungers—have been linked to a significantly increased risk of suffocation and are not recommended by the American Academy of Pediatrics (AAP) (6). Even for babies with reflux, the safest sleep position is always flat on their back, on a firm mattress, without inclines or sleep positioners.
During awake time, however, safe upright babywearing or snuggles on your chest can support digestion while maintaining your baby’s airway and comfort.
6. Probiotics: A Gut-Supporting Option
The infant gut microbiome plays an important role in digestion, immunity, and even reflux. One probiotic strain, Lactobacillus reuteri, has been studied for its potential to reduce regurgitation in breastfed infants (7). In randomized controlled trials, infants taking L. reuteri experienced fewer spit-up episodes and faster gastric emptying compared to those who did not (8).
Legendairy Milk’s Probiotic Drops include both L. reuteri and L. rhamnosus GG, two clinically studied strains. As with any supplement, we always recommend discussing probiotics with your pediatrician or lactation consultant to see if they’re a good fit for your baby’s needs.
7. When to Seek More Help
Some babies experience reflux that significantly interferes with growth, feeding, or quality of life. In those cases, medications such as H2 blockers or proton pump inhibitors (PPIs) may be considered. These prescriptions work by reducing stomach acid and can provide relief for babies with confirmed GERD or esophagitis (9).
Still, medications aren't always the first step, and not every baby with reflux benefits from them. That’s why it’s important to explore supportive care options first—including latch assessment, feeding position changes, and gut health strategies—while working closely with your pediatric care team.
8. The Legendairy Takeaway
We believe in empowering parents with knowledge, not pressure. Reflux can be multifactorial, and there’s no one-size-fits-all solution. What helps one baby may not help another, and that’s okay.
Here’s a quick recap of what may support reflux relief:
✅ Upright, chest-to-chest feeding and post-feed holding ✅ Safe tummy time (starting slowly and gently) ✅ Careful exploration of dairy or other sensitivities, if advised ✅ Burping frequently during and after feeds ✅ Avoiding fenugreek if symptoms worsen ✅ Supporting gut health with evidence-based probiotics ✅ Safe sleep—always flat and on the back ✅ Partnering with your healthcare provider for evaluation and care
Whether you’re navigating a mild case of “happy spitting” or something more persistent, you’re not alone—and there are gentle, thoughtful ways to support your baby.
My babe spit up sooo much after every feed. She had a very tight tongue tie (and could not transfer milk from the breast so I exclusively pump) She got the ties released at 5 weeks old but no improvement. The tongue was still tethered. We did a second release at 5 months old and what a difference!!!! No more spitting up. The air gulping that goes along with tongue tie can be a major cause of reflux in my opinion. Great article! ——— Legendairy Milk replied: ❤️❤️ Thank you for sharing, and so glad to hear your little one is doing well!
*These statements have not been evaluated by the Food and Drug Administration. Our products are not intended to diagnose, treat, cure, or prevent any disease.
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