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.”

  • We hit 3000 Facebook Page likes yesterday, but I'm not sure if Susannah Taylor or Kelly Dunlea was the 3000th like. We would like to send you both a little something when our supplies arrive in a couple of weeks. Kellly, I already have your address. Susannah, can you please message me yours? If someone knows Susannah can you please let her know? Wahoo, what a milestone!

  • There is also some recent medical research out along the same lines. I'll post the review article in the comments. Skip to the last page and the take home messages to decide if you want to read it. <a href="; rel="nofollow"></a&gt;

    Bath time is a lovely, splashy affair for little ones and a comforting signal to parents that bedtime is not too far away, and now research shows just how

  • And another one from Postnatal Depression Awareness Week. Sorry, that I'm a few weeks behind on my emails, but at least the information is still relevant: <a href="; rel="nofollow"></a&gt;">

  • <a href="; rel="nofollow"></a&gt;. - htm - sorry, I think I may have missed the week.

    The most risky time to become mentally unwell is after having a baby. Thirteen per cent of women in New Zealand suffer from Postnatal Depression with 20% suffering from anxiety during and after pregnancy*. Postnatal Depression Awareness Week is ...

  • Sorry for the long post but in desperate need of advice from people with experience. My baby girl is 10wks old today and from 1.5weeks old been medicated for reflux, first just Gaviscon, then added Rhanitadine. Doc upped the dose until we were on the max dose and it still didnt make a difference so doc switched to Omeprazole liquid, upping the dose every couple of weeks and still doing Gaviscon. Baby is still super uncomfortable, spilling (more like vomiting out of nose and mouth and it keeps going like she is vomiting not a 'normal' spill, freaks her out big time) after almost every feed (before we started meds it was after every feed, so have seen some improvement) and i can smell the acidity. She has diarrhea quite often and have had blood in her stools 3-4 times. Doc said today that shes out of ideas :-( She did prescribed us Pepti Junior to try and dropped Omeprazole to once a day. My baby is so tired, she wants to sleep but keeps wriggling and grizzling, just cant get comfortable so would really appreciate advice. We do all the usual stuff like having her elevated etc. *Reposting as had to delete other post to edit :-)

  • Gastric Reflux Support Network NZ shared Motivational and Inspirational Quotes's photo.

  • Gastric Reflux Support Network NZ shared Inspiring and Positive Quotes's photo.

    Thank you to all those strong parents out there who help out in this page!

    Inspiring and Positive Quotes <3

  • My baby is 7 weeks . she has low weight gain and doesn't feed well and has &quot;silent&quot; reflux. She is very gassy as She is currently on karicare gold + and lady from peads has suggested I try normal karicare infant and see how she goes till she sees us. But I've done some research and reviews are saying aptamil gold HA . any advice suggestions? I'm going to use gaviscon in the mean time .

  • can i post a question, why does nobody seem to answer reflux questions. Why can't the doctors help the mothers? my baby is 5 months old, we have run every possible test, gone through a lot. He does not sleep at night, wakes up 5 times. on the best most expensive milk. He is eating. Still wakes up. I don't understand, i cant go on like this, i look like a Zombie. make mistakes because i am so tired. gone to a Chiro, tested kidneys, the list is just never ending, seen several Peads. no luck. Surely in this day and age somebody out there knows what to do with reflux babies, seems every second mom i meet, has a reflux baby with no answers. And dont tell me it will get better, when, i need sleep.

  • Hey ladies. How do i know if my baby has reflux??? What are the signs?? My little girl (4weeks) spills quite often but not too often..? She just doesn't sleep in the day? Literally all day... Unless being held and up right.. Doesn't sleep well at night either unless up right on my chest? Hellllp. Shes breastfed.

  • For anyone who was confused by the information given on the news last night, this came through in my emails today: <a href="; rel="nofollow"></a&gt; so direct from the Ministry of Health rather than the media's interpretation.

  • There is a new question about sleep by Stephanie to the page. Does anyone want to share their experiences and help her out? Have a look at her question.

  • Hi :) can anyone please tell me their experiences with sleep training a reflux baby/teaching bub to self soothe?

  • The Gastric Reflux Support Network NZ's newsletter was out yesterday. There is some information in it about the BreastFedNZ app and also about how to join your Support Networks. If you are not a member and would like to receive the newsletter or have access to a Local Support Network or a Network for support on Feeding issues, Laryngomalacia or EGID / EoE, please complete a membership form: <a href="; rel="nofollow"></a&gt;

    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...

  • Gastric Reflux Support Network NZ shared Judy Arnold - Infant and child Consultant's photo.

    Judy is having a question and answer session today?? Head over to her page.

    It must be time for another question and answer time. Tomorrow afternoon 1 pm-2.30 pm. This is your opportunity to ask me questions. Spread the word,,,

  • Vikky Wintersgill-Taylor I used this page hundreds of times for help ya might get some tips x

  • 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!