NICE stepwise recommendations on infant regurgitation

This article outlines NICE recommendations for managing infant reflux and regurgitation and provides links to useful information.
Mother calming newborn baby

Functional gastrointestinal issues are common in infancy1. For example, around 30% of infants below one year of age will experience regurgitation1. This can be a distressing and confusing time for parents, who may not be confident in what to change or adapt to help their baby keep down their feed.

For first-line management of breast-fed infants who present with frequent regurgitation and marked distress, NICE recommends a breastfeeding assessment is carried out by a person with appropriate expertise or training.

For formula-fed infants NICE have developed a stepped-care approach2:

  1. Review the feeding history
  2. Reduce the feed volumes only if excessive for the infant’s weight
  3. Offer a trial of smaller, more frequent feeds – while maintaining the advised daily intake of milk (unless the feeds are already small and frequent)
  4. Offer a trial of a thickened formula (that contains rich starch, cornstarch, locust bean gum or carob bean gum)

  1. Vandenplas Y et al. Prevalence and Health Outcomes of Functional Gastrointestinal Symptoms in Infants From Birth to 12 Months of Age. J Pediatr Gastroenterol Nutr 2015;61(5):531-537.
  2. Nice. Gastro-Oesophageal Reflux Disease: Recognition, Diagnosis and Management in Children and Young People. January 2015. Available At: (Accessed April 2016).

COPD model

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Recorded webinars & presentations | Common Infant Feeding Problems | Prof Yvan Vandenplas
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aSTAR: Using NICE guidelines to manage frequent infant regurgitation

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