The baby/child is given a white strawberry flavoured liquid to swallow. For babies this will be administered from a bottle, or through a nasal gastric tube if necessary. An X-ray is taken by a Radiologist (X-ray Doctor), which is projected on a video screen, and then analysed.

This investigation is positive in approximately 50 to 60 percent of babies/children who clinically suggest GOR (gastro-oesophageal Reflux). The examination may demonstrate reflux, the wave pattern in the oesophagus, and the rate of emptying of the stomach. Importantly, this investigation shows whether the anatomy of the oesophagus and stomach are normal and if the baby/child has a hiatus hernia.

Babies/children with GOR may not reflux during the period of the screening, producing a normal reading. A Barium Swallow is therefore not a very reliable test for reflux, as it is possible for a baby/child to have reflux but it not to be picked up by this investigation.

It is common for the Barium preparation to cause constipation, and it should not be left to harden in the bowel. Therefore a laxative may need to be used if constipation is, or becomes a problem. It is useful to take the baby/child’s favourite bottle or cup to administer the barium preparation, as this may make the procedure more acceptable to them.


This investigation involves 15 minutes under a general anaesthetic if the symptoms and signs suggest reflux oesophagitis. The endoscopist (the doctor who performs the endoscopy) is able to assess the degree of oesophagitis (inflammation in the oesophagus), and whether there are any problems in the stomach and duodenum. A biopsy (specimen of the oesophageal lining) may be taken for pathological examination.

Other conditions such as coeliac disease (gluten intolerance), food allergies, lactose and other sugar intolerances, helicobactor pylori etc. can also be diagnosed from appropriate biopsies taken during an endoscopy.

This investigation is also a very important step before surgery is considered.


A probe sensitive to pH changes (thus an index of acidity) is positioned in the oesophagus. This investigation demonstrates the presence, frequency and duration of reflux episodes. For accuracy of result, the probe is left in the oesophagus for 18 – 24 hours, and an X-ray needs to be taken once the probe is in place to confirm it is positioned accurately.

This is a good test for determining whether a baby/child has reflux or not, and the severity of the condition. Several types of readings are taken, but the most crucial one is the % of reflux over 24 hours. In general: – under 5% is normal, 5 – 10% is mild, 10 – 20% is moderate and over 20% is severe. However, the severity of the condition is no indication of treatment needed e.g. a baby/child with mild reflux may still need Omeprazole, whereas a baby/child with severe reflux may remain well controlled on Zantac.


Diagnosing GER in Children –“The measurement of pH is the predominant modality used to diagnose gastroesophageal reflux (GER) in children. However, pH monitoring provides only part of the answer with respect to whether a child has reflux episodes. Multichannel intraluminal impedance monitoring can measure acidic and nonacidic reflux episodes using pressure-sensing electrodes along the length of the probe.” I haven’t heard of impedance monitoring being used in New Zealand.

baby colour large

© Gastric Reflux Association for the Support of Parents/babies (GRASP) and Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust (GRSNNZ) 2004. Used, edited and added to by GRSNNZ with permission.

Page may be printed or reproduced for personal use of families, as long as copyright and Crying Over Spilt Milk‘s URL are included. It may not be copied to other websites or publications without permission and acknowledgement. This information (unedited) was also provided (by GRASP) to health professionals in New Zealand to use ” to continue to support and inform families with babies/children with Gastro-oesophageal Reflux.”

  • Questions, questions...more people have posted questions on our page. Help me out and share your experiences. :-)

  • Does anyone with a baby with silent reflux use infacol as well as rhuger? I used rhuger for my first child but doesn't seem to be helping as much woth number 2 I just like that was its natural, rhuger has helped a bit but he's spilling up more now for some reason (10weeks old) advise appreciated ☺

  • Hi guys how do you feed your reflux babies? Do you find it best to let the baby drink the milk in 2-3 goes or do you find it best to have larger 20 minutes breaks?

  • Gastric Reflux Support Network NZ looking for answers

    Hi everyone - there are more questions to the page that you might be able to share your experience around.

  • Hi. Have a question for any parents who have used zantac to control silent reflux. Baby is responding really well to it but almost 3 weeks in it seems to be causing a bit if constipation. Have just started using coloxyl drops for that but I suspect it is making the reflux worse , has anyone noticed this with these two medications ? And are there any alternatives that you have found work well for constipation ? Baby is 8 weeks old . Thanks in advance 😊

  • Hi all. My lil(literally) 9 weeks old bubba born 2.1kgs at 37 weeks *iugr baby* has been diagnosed with GORD and has cyanotic/apnea episodes from it. He is on omeprazole, gaviscon and pepti junior but all these doesnt seem to help much and he still has these cyanotic episodes randomly (awake or asleep). He was admitted to the kids ward at waitakere hospital when he was 2 weeks old. Hubs and i resorted in taking turns in staying up taking care of him at night as he needs constant supervision. These episodes happen very silently and randomly so we dont know when it will happen or when it happens.. We also have 2 older toddlers.. anyway anyone else went through/going through the same thing? Should we bring bubs back to his gp? how do you get seen by a specialist?

  • ... And more posts to the page. :-)

  • Hi there, does anyone have experience/success with getting their baby allergy tested? I went to a herbalist on recommendation of a friend. He tested me for intolerances and as a result I am now on a strict dairy/gluten/yeast/egg/soy and corn free diet ($430 poorer and starving...the herbs have done nothing). I've been dairy and gluten free since miss 3 months was diagnosed with GERD at 3 weeks but I'm sure there is more to it as her poos are full of mucous and she is still in pain dispite being medicated. Any suggestions? :)

  • What is someone called who specialises in GERD? What kind of specialist are they? I think it's time for us to delve further into this issue that my 3.5 year old is dealing with. Recommendations appreciated. We are CHCH based. :) Will obviously go through my GP but nice to know if there is anyone in particular who is great? Thanks in advance!

  • Hi there, I have a three month daughter who has a NG tube in due to reflux and being lactose intolerant and not feeding. My daughter is currently on prescription formula as there was still lactose in my milk even though I had cut out all dairy. She is more comfortable and settled now but its still a battle to get her to take her formula, she had associated drinking with a sore tummy so we had to put tube in as last resort. I offer her the bottle first at each feed (currently trialling Dr Browns bottles) and give her a big break when she starts fussing and then try again, what she doesn't drink goes down the tube. I'm wanting to hear from anyone who's had a similar experience and any success stories, what worked etc. Thanks

  • There a couple of new posts to the page that some of you might be able to share your experiences about. Just an update on our Guidelines, as our Guidelines are also being updated: Please do not mention health professionals by name. You may be praising them but someone else may have a concern and the post could become damaging to the health professional concerned. As the moderators GRSNNZ reserves the right to remove or edit any posts: -that recommend another medication as being better or to treat conditions that it is not indicated for -any discussion where actual dosages of medications are mentioned as each child is an individual with differing needs (These are the most important ones in relation to this Page.)

  • My 3 month old baby girl has reflux and is very spilly. Just lately she's started bringing back up lots more of her feed, I'd say at least 1/2 of it every time. She's EBF and I wondered whether it was normal or if there's anything I can do to her get keep the milk down. Not just for her, but as we know, breastmilk is precious!

  • Hi there . Have a 7 week old who is breastfeed with silent reflux. We have just started zantac a week ago and it seems to be starting to work but still have had some bad moments where she is clearly in a lot of pain. Fingers crossed it will improve things. I discussed going dairy free with my gp but she wasn't convinced this would have any positive effect however I would like to try so as not to rely only on meds as baby has not put on any weight in the last week . Can anyone recommend online resources or books that provide info on a healthy dairy free diet plan for breastfeeding mums. Or lists of all foods to avoid that aren't obvious such as milk, cheese etc. Also has anyone also had nil or minimal weight gain on zantac ? She put on a kilo in the first 5 weeks and then just stopped despite good feeds and being otherwise happy when reflux isn't causing pain. She doesn't vomit either so confused over the weight issue as seems to have slowed prior to starting zantac. Thanks heaps in advance as this has me pulling my hair out almost 😕

  • <a href="; rel="nofollow"></a&gt;

    Does teething have a direct relationship to systemic symptoms? And what non-pharmacological approaches are effective in relieving teething symptoms?

  • <a href="; rel="nofollow"></a&gt; Pacifier Campaigns from Sesame Street - not what I was looking for, but for any of you trying to loose the Pacifier with an older child this could be useful. Now back to looking for my colouring in supplies!

  • Hi everyone I'm looking for some advice for my toddler. He is now 2 years old and was a reflux baby and with the help of medicine he came right at about 6 months old . Ever since I started solids training at 6 months old food has been a nightmare and it's only just taken me til now to wonder whether his food aversions have anything to do with the reflux as a baby? He has never eaten fruit or veges voluntarily and I have to sneak them into to foods and even then he sometimes catches on - how can you know you don't like something if you've never tried it ? He basically wants to live on bread and crackers and hot chips, he won't eat most meat except chicken, won't eat pasta, I have tried everyone for help and no one knows what to do as I've tried everything and it's doing My head in. If this is connected to his reflux as a baby what can I do ? Sorry if this isn't the right place but every meal is a battle - I don't yell, I'm calm, I sit with him and feed him the same meals as me and he just says no :( I want to wean him off formula completely (have already cut the formula right down) but at this stage it's the only way I can get any nutrients and vitamins in him. And no he won't touch yoghurt or smoothies or juices - only water :(

  • Gastric Reflux Support Network NZ shared Linkage's photo.

    Thank you Linkage!

    Something to live by....

  • Hi I have an 8 week old prem (6 weeks early so 2 weeks corrected) suffering from reflux. She is exclusively breastfeed and the dr has prescribed gaviscon. I am having real difficulty in getting her to take it. I have tried syringing it and also tried to feed via a bottle (she had never had a bottle for anything before) but she is just refusing it or spitting it back out. Does anybody have any tips for getting bubs to take the medicine?

  • Gastric Reflux Support Network NZ shared Plunket New Zealand's event.

    There might be some of you who are interested in joining Plunket's Chat on Toddler Sleep. Please head over to Plunket's Event.

    Join our PlunketLine nurse Carla for our 'Toddler Sleep' chat on Wednesday the 26th of August from 8-9pm. Post any questions you have below or private message us and we'll be sure to answer your question during our chat. The chat will take place on our timeline with a 'chat open' post at 8pm.

  • Wow yesterday Gastric Reflux Support Network NZ had 5 new members in one day! I think this is a record. If you want to join also: <a href="; rel="nofollow"></a&gt; I haven't processed most new members from this week as my middle daughter has been very sick with glandular fever. I'll do this as soon as I can. Roslyn Ballantyne, National Coordinator

    Gastric Reflux Support Network NZ for Parents of Infants & Children Charitable Trust Membership & Confidentiality Agreement Form First Name: Last Name: Email Address: Street Address: City/Town: Area: Auckland Canterbury Gisborne Hawkes Bay Marlborough Nelson Northland Otago Southland Taranaki...

  • Hi there, im new to this page and I've just found out my 12week old has gastric reflux. We are currently going through a growth spurt and she appears to be in more pain from the extra milk intake, has anyone experienced this? I'm thinking about taking her to the hospital to get some pain medication....

  • Hi all, Just wondering if any of you have had a similar experience. My 7 month old is on omeprazole 2ml morning and night. For a few nights we have accidentally forgotten to give it to him... And then the last 2 nights he has screamed blue murder for hours. He would go down ok but then wake and cry for hours like he is in pain. Nothing will console him. Its the only thing we have done differently - has anyone has a similar experience??? Thanks! Bec

  • Hey! Day 4 on gaviscon for our 4 week son and he's constipated any suggestions to get him going?

  • Hallucinations on Omeprazole!? ... Forgive me if this has been discussed recently or at all (probably not I'm guessing) I was active on this page when my daughter was just a baby with terrible reflux. She was on omeprazole back then until about 8-9 months old. She is back on it as of a week and a half ago just to trial whether her frequent cough and waking in the night could be reflux back at age 3.5!!!!.... Anyway, for the last 4-5 nights she has woken terrified that there are worms in her bed and on her body. (It is not a nightmare or a night terror) last night was the worst night yet! Awake from 1-5am with the most frightening hallucinations yet. Worms and flies all through the bed, on the ceiling and even as I consoled her she screamed that they were all over my face :( it was heartbreaking. Even with all the lights on she could see them. I could go on describing this but I won't. My question is has anyone's child or you yourself experienced the very rare (but documented) side effect of hallucinations? Needless to say I am stopping the meds today.

  • Please tell me someone is in the same boat... Our son can't sleep for longer then a few minutes at a time without gagging on his reflux and waking himself up. Normally the only way for him to get any sleep is to sale him and hold him vertical against our chests. He is on Gaviscon, Omeprazole (losec) and we've just dropped Ranitidine (Zantac) and added Domperidone. Nothing so far is helping to resolve this sleep issue. His bed is on a steep incline but often the moment you put him in it he starts spluttering and throat clearing loudly until he wakes. He's 9 weeks and I've been dairy free breast feeding for about a month. He has now started Neocate formula. Anyone else have a baby who can't stay asleep because of reflux? Any tips?