How Your Baby’s Spit Up and Acid Reflux Affects Sleep

Baby Sleep Acid RefluxThe diagnosis of baby acid reflux appears to be on the rise. We talk to many parents each week and a good number will have babies with reflux. Although it seems to be diagnosed more now, babies having reflux is actually not new and very common. This article will talk about your baby’s spit up, infant reflux, and how it may affect your baby’s sleep.

What is baby acid reflux?

First, what is reflux? The medical name is Gastroesophageal Reflux and some know it by GER. All this means is that stomach contents come back up the esophagus. The definition of “reflux” is “a flowing back.” When put that way, it shows you just how common it is. Babies are known to spit up a lot and I’m sure many of us can relate to how cute newborn clothes are, but they are only on your baby for a couple hours at a time and you’re doing laundry daily due to spit up!

And, why do babies spit up?

Your baby spits up or has reflux due to an immature digestive tract. As your baby grows, the tract will mature and less stomach contents will be regurgitated. The ring of muscle where the esophagus meets the stomach is soft in a baby and becomes firmer as your baby grows. Most babies outgrow spitting up and reflux by 12-18 months old.

What are the signs and symptoms of reflux?

The biggest symptom, of course, is spitting up (usually after a feeding, but not always), but if your baby has “silent reflux” he can be uncomfortable without the spit up, too. Your baby may also be fussy during a feeding and some even cry while you’re feeding them. :( You might hear gurgling sounds during or after a feeding. If your baby cries a lot when laid on his back after a feeding, he may be experiencing discomfort from the food traveling back up. If your baby eats smaller, frequent meals, refusing to eat larger bottles compared to other babies his age (within reason), he may be experiencing reflux.

Do you have to worry about your baby’s spit up and reflux?

For most babies, some spit up is normal and it does not bother them too much. Some even call them “happy spitters.” If your baby is having enough wet diapers, is gaining weight appropriately, and otherwise happy and content, your doctor will most likely not prescribe any medication for the reflux. Some babies will feel uncomfortable immediately after spit up or a feeding, but otherwise may be okay, and those babies won’t usually get medication, either. For more severe cases of reflux, your baby may not eat enough or spit up too much, and can have weight gain issues. Others are simply miserable much of the day and have more frequent night-waking. For these babies, your doctor may prescribe medication, which we have begun to hear more and more about lately. If you are concerned about your baby’s spit up and suspect she may have a more severe case of acid reflux or a more serious condition, please do talk to your baby’s doctor.

How does your baby’s reflux affect sleep?

Babies with reflux typically need to eat smaller, more frequent meals. This avoids their tummy being too full, which can increase the likelihood that food will come back up. Your doctor will also likely tell you to feed your baby upright and to keep your baby upright for a period of time after eating (usually ~20-30 minutes), before laying him down on his back. A baby with reflux will then need special sleep strategies. Here are some tips:

  • Consider raising up one side of the crib mattress such that the baby is sleeping with an incline. Of course, you have to be cognizant about a mobile baby rolling too far down to the other end of the crib. You can consider something like the Baby Stay Asleep for your baby to keep her from moving around too much.
  • Have appropriate expectations. Can you get your baby with reflux who wakes every hour to sleep 12 hours straight? Maybe, Maybe not. It doesn’t mean you can’t improve your baby’s sleep and I do encourage parents to try using a No-Cry or Limited-Crying Sleep Training Method, because too much crying can aggravate the reflux.
  • For severe cases of GERD, I recommend getting the reflux under control prior to helping your baby learn to sleep better. If you’re just starting medication, allow for some time to see if the medication is working before starting to teach baby new sleep habits. If you are wondering if baby is uncomfortable because of reflux, then this will likely lead to too much inconsistency and more frustration for all of you.
  • If you are sleep training, make sure you move the feeding earlier in the bedtime routine. If you have to hold your baby for an additional 20-30 minutes after a feeding, it increases the likelihood that she will fall asleep being held. This is NOT a problem UNLESS she then wants to be held all night and is no longer a newborn. We learned that sleep associations play an integral part in your baby’s sleep.
  • You may have to night wean your baby LATER than average or other babies her age. Your baby’s health is the #1 priority and although sleep is important for her growth and development, too, making sure your baby is eating enough is a higher priority.

Although it’s been said that breastfed babies spit up less, both my boys spit up and I breastfed for their first year. My youngest spit up a TON!! He was, thankfully, a “happy spitter” though and we never had serious reflux issues. We used cloth diapers as burp cloths and rarely picked him up without one on our shoulder. We’d go through many outfits and cloth diapers every day. I have many clients with babies with reflux, and once they have the reflux under control, either by medication or by changing routines, babies with reflux can go on to be good sleepers just like the rest of us.

If you’re looking for ways to get your baby or toddler into a healthy sleeping routine, please be sure to pick up your FREE copy of 5 Ways to Help Your Child Sleep Through the Night, our e-Book with tear-free tips to help your baby sleep better. For those persistent nighttime struggles, check out The 3-Step System to Help Your Baby Sleep (babies) or The 5-Step System to Better Toddler Sleep (toddlers). Using a unique approach and practical tools for success, our e-books help you and your baby sleep through the night and nap better. For those looking for a more customized solution for your unique situation with support along the way, please consider one-on-one baby and toddler sleep consultations, where you will receive a Personalized Sleep Plan™ you can feel good about! Sometimes it’s not that you can’t make a plan. Sometimes you’re just too tired to.

How did your baby’s reflux affect sleep? Was it severe?


Journal of Human Lactation –

The Mayo Clinic –

While The Baby Sleep Site™ publishes what we consider to be safe tips and suggestions, all The Baby Sleep Site™ content is made available on an as-is basis, with no warrantees expressed or implied. This publication is not intended for use as a source of medical advice and we encourage communication with your baby’s pediatrician, particularly for medical issues such as reflux.


  1. Stephanie says

    Liam cried for the first 3 months of his life. From terrible gas, to colics and ending with terrible reflux, he finally found his happy, quiet place once he began his medication. What a different boy!

    He went from sleepless nights, to sleeping well between nursing sessions, he was able to extend his 45 minute naps once in a while and after a month, he actually started waking less for night-feeding, and taking regular 1h30 naps twice a day.

    Teething came into play at the end of the fourth month and the two beautiful, perfect weeks of one feeding in 12h nights and 2 gorgeous 2h naps during the day came to an end.

    About a week after the teething, he began sleeping better again, and I tried stopping the meds. He was fine without it… but hungry, so I started the cereals and he is now waking 3 times per night again, and only taking 45 minute naps during the day.

    He is 10days shy of 6mo and I suspect his reflux/digestive track is sensitive and he is adapting to the new food, even though he really enjoys it.

    So yes, in our case, the reflux severely affected sleep until he was diagnosed and was put on meds. Then, after a week of sleep training, we had a terrific month and a half until the introduction of baby cereal. Our journey continues as his system adjusts to the new menu…

    My first born (she is now 2) was sleeping through the night at 1mo and a half… I’m so tired right now with Liam still waking several times through the night at 6mo.. urgh… but like you said, making sure he is eating enough is the number 1 priority.

    I SO look forward to the end of our reflux/sensitive system days…

  2. Jen B says

    My son had “silent reflux” which is heartburn without spitting up so it was hard to diagnose. He ate very small meals but was always hungry. And would scream whenever you put him down. It peaked at 3 months when we finally figured it out. And yes his sleep was awful because he was hungry all the time. With medication he was much better. Just be aware that your baby doesn’t need to spit up to have reflux.

  3. says

    @Stephanie Awww! It sounds like a rough start for Liam, but I’m glad you figured it out and got it under control! I hope he outgrows the reflux very soon. Thank you for sharing!

    @JenB Ah yes, “silent reflux.” Thank you for bringing that up. I’ve updated the article to explain there doesn’t have to be spit up to have reflux, either. Thank you for commenting!

  4. Jen B says

    It’s funny, at that time in our lives (before I found you) all these sleep experts and baby books all basically said if your baby has reflux or collick, then you are on your own as far as how to get your baby to sleep. I wish I had found you then because I’m sure you would have been much more supportive. My son would eat every two hours all day and night, because like your article says, they will eat smaller meals more frequently. It was so tough. Fortunately the medicine worked quickly and we were able to lengthen times between feedings at night which was great. Thanks for this article!

  5. Christine says

    My son never spit up after he was born and progressed very well in the sleep department. By three months he was sleeping six to seven hours at a time. I was so happy to be getting sleep again. Then everything changed, he started waking more and more frequently. At his worst he was waking every 45 minutes and sometimes every 15 minutes. I thought it was a fourth month sleep regression but by five months nothing was getting better. He had started spitting up like crazy around four months but I brushed it off, babies spit up right, then I noticed his breath and hands were smelling like stomach acid. I felt so bad I didn’t notice sooner then five months. Poor kid. He’s on medicine now and sleep is slighty improving over time. It’s a super slow process waiting for his sleep to improve again. Just taking one day at a time right now.

  6. Jill says

    Our daughter was a silent refluxer and was finally diagnosed after 3 terrible months. By that time I had switched to exclusively pumping for her because she would only eat if she was asleep (not conducive to nursing obviously). She would only sleep for 45 minutes at a time ever and we were exhausted. She was put on two different types of meds which helped with the feedings somewhat. Sleep was still a major issue as she needed to be upright in her swing to keep the food down and sleep for up to 1.5 hours. Anytime we tried sleep training (before I found this awesome site), she would end up crying and throwing up. As the months passed, we just gave in to her needs and did what was necessary in order to get sleep for ourselves (including co-sleeping which I was very opposed to). I found this site around the time she was 10asleep months and she had finally started

  7. Jill says

    Sorry for the break in message…
    I found this site around the time she was 10 months and was finally starting to make progress with her reflux. I was encouraged to devise a plan that worked for us and allowed me to sleep. With a very gradual approach, she learned to fall asleep without me, in her own bed and stay there for a few hours! Now, she is almost 18 months and is finally off her meds, sleeping 12 hours at night and taking at least a two hour nap. She puts herself to sleep and there are zero tears most nights. We are having our son tomorrow via induction and I am praying he doesn’t have any of the same issues but am so grateful to have these resources to help if needed. Lessons learned: my little left handed redhead has a plan of her own, seek out help from knowledgeable, flexible resources and there is no single cure for sleep trouble and flexibility and patience and key!

  8. Sarah says

    We had a huge problem getting heard by the medical staff, including midwives when our son was having problems. Our best resource was pages such as these and other forums where parents talked about their issues etc. I was treated like I was a bad mother as had huge issues with breastfeeding, and we were frowned upon when we took our son to the doctors because he wasn’t sleeping, he just screamed when we put him down. We were told thats what babies do, they don’t sleep through the night. We were feeding him, keeping him upright for 1 hour and then it would take us a further hour to get him settled because he was in pain……. and they said this was normal! We saw 7 different doctors, one even told me I was feeding him too much and I should be doing 10 minutes on one breast and 10 minutes on the other and that should be enough for him. We were outraged and it took my husband demanding to see a specialist that we got help and reflux was confirmed. Our son was seriously struggling, he was found to have tongue tie 3 weeks after birth, so he wasn’t feeding properly either and with the reflux his first few months were terrible for him :0( I was ‘encouraged’ not to use a breast shield (which had been working in hospital and he had been feeding well with). Our son is now nearly 8 months and 9.31kgs he loves his food and against a tough start is having a great time now. When I look at photos of him in the early months I now realise how much he was struggling. We were told at one stage that reflux wasn’t an issue for him unless he lost weight!!!! I feel that there is some serious education that all doctors should have, parents should be told about colic, reflux and other issues at classes and one message I have for parents is IF YOU THINK THERE IS SOMETHING WRONG STICK TO YOUR GUNS AND MAKE YOURSELVES HEARD. IT’S YOUR CHILD.

  9. Stephanie says

    To moms going through it right now..

    I would recommend not worrying about sleep schedules and sleeping in own crib and rigid rules/methods you had given yourself prior to having the baby… this is about SURVIVAL! =)

    I never wanted to co-sleep with my babies because I couldn’t sleep well with those little ones so close to me, and didn’t want the hassle of training them later on to sleep in their own bed.

    In the early months, DO WHAT YOU NEED TO DO TO GET SLEEP! My poor Liam had such a hard time with his reflux, being near me brought him comfort and would allow him to get some sleep and in return, I was so exhausted, that I would get to sleep too, never mind all my fears about co-sleeping.

    Most of the time, however, I was intent on having him sleep in his bassinet next to my bed… and we both would be miserable. Looking back, I should have let him sleep with me as much as he (and I) needed to.

    While he was sick, I had to help him to sleep ANYHOW, and once he got better, had to train him to learn to fall asleep on his own so I had to go through the sleep-training I was trying to avoid in the first place!

    Just GET SOME SLEEP, and what ever sleep association is created… it can be fixed later on when the baby is 4mo or 6mo and happy. And it isn’t too hard, and doesn’t take too long.

    Plus, you have Nicole’s support and all the other moms on this site!


  10. Maree says

    We had a miserable 3 months until our daughter was diagnosed with reflux. But what a difference once the meds kicked in. I still fed her through the night until eight months because i felt she needed the extra nutrition and the night feed was always the best feed – she would take both sides whereas during the day she would only feed from one breast at each feed. But be warned it doesn’t always correct itself by 12-18months – my daughter is now two and still on meds. We have tried twice to slowly reduce the dose (one granule out each fortnight) but each time we reach a stage where she starts waking during the night, one time at first and then as the medication is decreased further it increases to two or three wakings and then finally the waking and coughing kicks in – that is the time the meds are upped again until she is sleeping through. Getting her night sleep is most important as it makes all our lives easier, since she has never been able to sleep much during the day. Our Doctor has been fantastic and always supportive. If your doctor doesn’t listen find another who will – a screaming baby every night when they are laid down is not normal.

  11. Debbye says

    @ Jen B- Thank you for sharing. We are so happy that you find the articles and information helpful! And are so happy that your little one is doing so much better now! :)

    @ Christine- I am so glad that you did find out about your baby’s reflux when you did, and it is sometimes a long road to get reflux babies to better sleep. One day at a time is all you can do, and stick with it! Keep up the heard work. :)

    @ Jill- Thank yo so much for sharing your story! I hope your little red head is enjoying her new little brother, and CONGRATS! You will definitely be more prepared this time around should your son have any of the same issues, but more than likely he will surprise you with his own set of rules! :)

    @ Sarah- Thank you for sharing your story, and i am sorry you had suck a battle getting help for your son. You are absolutely right, in that we should fight for what we know and trust our instincts! I hope your son continues to grow and thrive! :)

    @ Stephanie- Thank you for your words of wisdom! I have been there too with my son, and agree! Best wishes! :)

    @ Maree- Thank you for sharing your story, and for bringing it to light that though many do outgrow their reflux earlier, it is not always outgrown in the first year. I hope your daughter is doing well, but she certainly will be outgrowing her meds in her own time! Kudos to your Doctors too, for being so supportive. Best wishes to you and your family!

  12. Marilyn says

    *Sigh* Thanks SO much for this article. I was starting to feel pressure to get my daughter on a schedule and sleep through the night, etc. but she hasn’t been able to yet. We also had a very rough start. She was 2 months old when it started to get bad. It took a while to diagnose her (silent reflux :() and now, at six months, she’s on meds (and I’m dairy and peanut free) and we’ve had a couple weeks of her doing much better.

    My pediatrician scolded me for not having her on a eat play sleep schedule and said it should get her sleeping through the night. But whenever she tried to have “full” feedings and have that routine her reflux would get worse. Now she refuses to eat a lot at one time. She knows it makes her feel bad! Your article helped confirmed the things I was feeling and seeing in what worked for her and helped take the Dr. guilt trip off my shoulders. It’s so nice to know that I’m not alone in this because dealing with reflux in an infant can be so confusing and exhausting.

    P.S. Thanks to all who make this website possible. I found it when my first was a few months old. He was the perfectly on schedule one (eat play sleep) 😉 thanks to your help. :) He’s now almost 3 and still a great sleeper!

  13. says

    Thanks for the article! My baby shows signs of acid reflux but when I went to my doctor he told that it would go away soon. Can I support this by avoiding some kinds of food like citrus fruits?

  14. Debbye says

    @ Marilyn- Thank yo so much for sharing your story! It is unfortunate that caring for our babies should lead to any guilt or confusion, and I am so happy that you guys are on the right track now! I hope things continue to improve!!!

    @ Darcy- Thank you for writing! You can feed smaller more frequent meals and avoiding citrus fruits is a good plan, as they are hard for young babies to handle. Follow your Doctor’s recommendations and follow up if you have any concerns. You may be able to find some more helpful information here:
    Good luck!