What is Silent Reflux?

Silent reflux can be very confusing; there may be no obvious signs of gastro-oesophageal reflux (such as vomiting) and the child generally isn’t ‘silent’.

Silent reflux refers to refluxed material that flows back into the oesophagus, but isn’t forced out of the mouth. The child may swallow it back down or the stomach contents/stomach acids may not come up the oesophagus far enough to be swallowed. It has the potential to cause more damage because it can sit in the oesophagus longer than if the child vomited.
Medical intervention may be necessary because the same complications can arise as in other forms of gastro-oesophageal reflux; however, it may be harder to recognise without any noticeable vomiting.

If they feed as a means of soothing their pain i.e are comfort feeders as well, then poor growth may not be an issue, and they may in fact have huge weight gains. This can also contribute to a delay in diagnosis.

Some people mistakenly believe the term ‘silent reflux’ refers to a child who does not cry with their reflux, but this is not the case.

For more information on signs and symptoms of gastro-oesophageal reflux, please see the article ‘How Reflux Presents’. If you suspect your child may have reflux (either gastro-oesophageal reflux or gastro-oesophageal reflux disease), or have any questions or concerns, it is important to discuss them with your child’s doctor or child health nurse.

Points to remember

  • Not all children suffering from reflux actually vomit; some may have what is termed ‘silent’ reflux – where the stomach contents only come part way up the oesophagus. Any form of reflux may disturb the child and cause problems.
  • Parents may notice any of the other signs of reflux apart from the obvious one – vomiting/regurgitation. They may hear the baby or child reflux, or see them swallow repeatedly, and see no evidence of it.
  • Some children can have silent reflux that presents with asthma or ear, nose and throat issues, with no obvious signs of reflux e.g. regurgitation.

Download printable version What is Silent Reflux

For more information on this topic, see the presentation at our 2013 conference by Professor Geoff Cleghorn, Paediatric Gastroenterologist on Diagnosis and medical management of infant GORD – introductory clip. Buy full version here.

© Written by Glenda Blanch, RISA Inc member and author of “Reflux Reality: A Guide for Families” in association with RISA Inc; revised 2010.
Additional information on gastro-oesophageal reflux is provided in our book “Reflux Reality: A Guide for Families”.
RISA Inc – families supporting families

Information reviewed by:

Dr Anthony Catto-Smith,
Director, Department of Gastroenterology and Clinical Nutrition,
Royal Children’s Hospital,
Melbourne. Victoria. Australia

With the exception of Professor Geoff Cleghorn’s presentation which is his own work. 

Last updated: July 2021