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Should a baby still be placed on the back to sleep if they spit up a lot or have reflux?

Some babies have GER (also known as reflux) or GERD. GER (gastroesophageal reflux) is normal spit up. GERD (gastroesophageal reflux disease) is when the reflux causes other symptoms such as poor weight gain. GERD requires a medical diagnosis and is very rare in babies under age 1.

The American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology and Nutrition recommend back sleeping, even for infants with reflux. Elevating the head of baby's crib or having baby sleep in a car seat or swing are not recommended. Elevating the head of the crib may cause the baby to slide down into a position that may compromise breathing. 

Parents can do the following to help reduce how much a baby spits up:

  • Hold baby upright after feedings.
  • Limiting the baby’s activity after feedings.
  • Burp baby frequently during and after feedings.
  • Provide more frequent, smaller feedings.
  • Reduce a baby’s exposure to smoke in the home.
  • Breastfeed.