Infant reflux is a widespread and often troubling condition that affects many babies and their families. More types of reflux exist. Infant gastroesophageal reflux (GER) or regurgitation is a normal physiological condition in which stomach contents flow back into the esophagus. In some cases, it can progress to classic reflux or gastroesophageal reflux disease (GERD), characterized by more severe symptoms and potential complications, causing discomfort, irritability, excessive crying and frequent spitting up, or, in the case of silent reflux, with minimal visible symptoms. Silent reflux (Laryngopharyngeal Reflux) does not always involve visible regurgitation but can still cause significant discomfort, leading to fussiness, chronic coughing, hoarseness, and disturbed sleep. While GER often resolves naturally, persistent symptoms, particularly in classic and silent reflux, can disrupt feeding, sleep, and parent-infant bonding.
Parents frequently seek gentle, drug-free ways to support their baby’s wellbeing, especially when standard advice offers limited relief. Emerging research suggests that osteopathic treatment may offer effective, non-pharmacological relief. Therefore an increasingly supported option is osteopathic manual therapy — a soft, hands-on approach.
Understanding Infant Reflux and Silent Reflux
Gastroesophageal reflux (GER) is common in infants under one year old; due to their immature digestive systems, it occurs in over 50% of infants under three months old. It typically peaks around four months and resolves by 12 to 14 months of age.
Symptoms of classic reflux or gastroesophageal reflux disease (GERD) include:
- Frequent regurgitation or even projectile spitting up
- Irritability during or after feedings
- Irritability when placed supine
- Arching of the back
- Poor sleep or frequent night waking
- Excessive crying and fussiness
- Can be very unhappy in the car seat
- And the same symptoms as seen in silent reflux may occur
Silent reflux may not involve visible spit-up. Instead, symptoms include:
- Irritability without obvious regurgitation
- Frequent swallowing, excessive swallowing or throat clearing
- Hoarseness, wheezing or chronic coughing
- Refusal to feed or difficulty feeding
- Gagging or choking
- Excessive crying and fussiness
- Disturbed sleep or waking soon after lying down
- Apnea-like episodes
Both types of reflux can impact:
- Growth
- Comfort
- Feeding
- The infants and parental stress levels
Traditional Management Strategies
Conventional approaches to managing reflux often involve:
- Positional therapy
- Feeding changes
- Allergen reduction in breastfeeding mothers
- Medications are used in severe cases.
Due to concerns over pharmaceutical side effects, many parents are exploring gentle, hands-on approaches like osteopathic and manual therapy.
How Can Osteopathy Help?
Osteopathy is a form of manual therapy that supports the structure and function of the body. Paediatric osteopaths work gently with babies to release physical restrictions and enhance nervous system regulation. Osteopathic manipulative treatment (OMT) involves gentle techniques to relieve tension and improve physiological function.
For infants with reflux or silent reflux, these therapies aim to:
- Improve diaphragmatic mobility, releasing tension around diaphragm and stomach
- Support the vagus nerve and parasympathetic tone
- Ease restrictions to increase movement in the cervical spine, thorax , rib cage, and skull structures
- Enhance digestive motility to ease the abdominal restriction and visceral fascia’s tension to reduce discomfort.
What Does the Research Say?
A growing body of scientific evidence supports the use of manual therapy for infants with digestive or musculoskeletal complaints, including reflux:
- A 2023 systematic review and meta-analysis by Matar et al. found that manual therapy significantly improved symptoms of infant gastroesophageal reflux disease (GERD), reporting an odds ratio of 4.63 and a notable improvement in Reflux Disease Questionnaire scores. Importantly, no adverse effects were reported. (Matar et al., 2023)
- In a randomised controlled trial published in Healthcare (Cerritelli et al., 2023), infants receiving osteopathic treatment for colic — a condition with overlapping symptoms to reflux — experienced significantly reduced crying episodes and regurgitation. (Cerritelli et al., 2023)
- A 2025 clinical study by Fiori et al. in BMC Pediatrics found that parents of infants receiving osteopathic treatment reported substantially lower stress levels, further highlighting the holistic benefits of this approach. (Fiori et al., 2025)
- Liem & Sabbini (2013) documented case-based evidence on osteopathy alleviating reflux through cranial and visceral techniques.
Benefits of Osteopathic Treatment Reflux and Silent Reflux:
Osteopathy is a gentle, holistic approach to managing both classic and silent infant reflux. It offers a drug-free solution with few reported side effects and is supported by growing research and clinical use, providing relief to infants and reassuring families. Osteopathic treatments are:
- Gentle, safe and pain-free therapy
- Reduction in visible and silent symptoms, reduces digestive discomfort and crying
- Improved sleep and feeding routines
- Better digestion and comfort post-feeds, which may improve feeding and sleep patterns
- Reduced stress and anxiety in parents and encouraged parental involvement
When Should You Seek Osteopathic Help?
You might consider a paediatric osteopathic consultation if your baby:
- Cries frequently and is hard to soothe
- Has feeding difficulties or refuses the breast/bottle
- Spits up frequently or shows signs of silent reflux
- Sleeps poorly or wakes frequently, often in a scream
- Seems unsettled after feeding or during burping
Choosing a Qualified Osteopath
When considering osteopathy for infant reflux or silent reflux, to ensure safety and effective care, the Osteopath must
– Be authorized with extensive postgraduate pediatric training
-Take time to assess your baby’s birth history, feeding, sleep, and general development
– Monitor your baby’s response and progress
– Combine manual therapy with supportive feeding and sleeping strategies
– Be able to work in collaboration with your health visitor, GP or pediatrician.
For many families, osteopathy offers a holistic, respectful, and baby-centred approach to managing reflux and silent reflux. By relieving strain in the baby’s body and enhancing its self-regulating abilities, osteopathy can promote comfort, ease, and connection during the challenging early months of life.
Ready to Support Your Baby Naturally?
If your baby is experiencing symptoms of reflux or silent reflux and you’re exploring safe, non-invasive treatment options, consider booking an appointment with a qualified paediatric osteopath.
You can schedule a visit here: https://qklinik.dk/en/bestil-tid/
Or watch our video on baby osteopathy and infant reflux here:
https://youtu.be/luX71qeoOWk?si=zQMayoftKlRaPP2j
Incorporating skin-to-skin, gentle massage, white noise, swaddling, and feeding adjustments can all help reduce discomfort alongside osteopathic care.
References
Cerritelli, F., Barlafante, G., Pascucci, F., et al. (2023). Osteopathic manual therapy for infants with colic: A randomized controlled trial. Healthcare, 11(18), 2413. https://pubmed.ncbi.nlm.nih.gov/37761797/
Fiori, P., Cerritelli, F., et al. (2025). Effect of osteopathic treatment on parental stress in infants with colic: A clinical study. BMC Pediatrics. https://pubmed.ncbi.nlm.nih.gov/39885436/
Matar, A., Matar, A. A., et al. (2023). Manual therapy for gastroesophageal reflux disease: A systematic review and meta-analysis. Thieme E-Journals. https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0043-1777296
Liem, T., & Sabbini, A. (2013). Osteopathy in the cranial field and gastroesophageal reflux in infants: Clinical observations. In ‘Osteopathic Medicine: New Perspectives’. Springer. https://link.springer.com/chapter/10.1007/978-3-319-00846-2_264
