Reflux and sleep

This guide is general information only and isn't a substitute for medical advice. If you're concerned about your child's health, or they're unwell, please see a doctor.

Reflux is common, exhausting, and surrounded by product marketing that quietly contradicts safe sleep advice. The most important thing to know is that the fix you'll be offered most often, tilting the mattress, is not recommended. Here's the guidance, and when to see your doctor.

How common it is

Red Nose notes that reflux is common for up to half of babies under three months of age, and for 70% of healthy babies under one year. Most reflux stops after six months, and has completely stopped by twelve months for 95% of babies.

Most of what parents call reflux is the normal, harmless bringing-up of milk, and it usually causes no pain and no problems with weight gain. A smaller number of babies have gastro-oesophageal reflux disease (GORD), where the reflux is frequent and comes with other symptoms of concern, and that is worth a doctor's assessment.

Do not elevate the cot

This is the key safety point. Red Nose advises that babies with reflux are placed to sleep on their back from birth, on a firm, flat mattress that is not elevated at one end, because tilting the sleeping surface does not reduce reflux and is not recommended.

The reasons are practical and serious. A baby on a tilted surface may slip down under bedding, covering the head and face, or into a "chin on chest" position that makes breathing harder; a pillow used to prop a baby up can be a suffocation hazard and can push the chin onto the chest, reducing airflow; and an inclined surface encourages the head to fall forward, which can block the airway. Red Nose warns specifically against inclined sleep products.

What you can do

• Keep your baby upright for about 15 to 20 minutes after a feed, which can ease the problem.
• Keep every sleep flat, firm and on the back, in their own safe sleep space.
• Expect it to improve with time. Most cases get better on their own and don't need treatment.

When to see a doctor

Raising Children advises seeing your GP or child and family health nurse if your baby has trouble swallowing, a fever, seems irritable or won't eat, is vomiting a lot, isn't gaining weight or is losing weight, or has a chronic cough or recurrent chest infections. Crying a lot, pulling up the legs or knees, and arching the back are also worth mentioning. Take your child to a hospital emergency department if there is blood in their vomit, or the vomit is green.

Reflux that is affecting feeding, weight gain or your baby's comfort is a medical question, not a settling question. Get it assessed before starting any sleep program, since a settling plan built on top of untreated reflux tends to fail.

Sources

• Red Nose Australia, My baby has reflux
• Red Nose Australia, The dangers of inclined sleep products
• Raising Children Network, Gastro-oesophageal reflux and GORD 0 to 2 years
• Red Nose Australia, Six safe sleep recommendations

Last updated: July 2026. Sources include Red Nose Australia and Raising Children Network where cited above. This guide is general information only. For individual concerns, see your GP or child health nurse.