What Is Aerophagia?

Aerophagia, derived from the Greek words "aero" (air) and "phagein" (to eat), refers to the unintentional swallowing of air. While it’s normal for everyone to swallow small amounts of air during eating or drinking, excessive air swallowing can lead to uncomfortable symptoms—particularly in babies. For infants, aerophagia is often linked to feeding issues, which exacerbate reflux symptoms and create a cycle of distress for both baby and parent.

In the context of reflux, aerophagia increases the pressure inside your baby’s stomach. This excess pressure can push stomach contents, including acid, back up into the oesophagus, worsening reflux and causing pain.

What Causes Aerophagia in Babies?

Several factors can contribute to a baby swallowing excess air. Some of the most common causes include:

1. Poor Latch During Feeding

A shallow or improper latch can cause air to be swallowed during breastfeeding or bottle feeding. Babies may struggle to form a tight seal, allowing air to enter alongside milk.

2. Milk Flow

An overactive letdown or bottle nipple with too fast a flow can overwhelm a baby, causing them to gulp milk and swallow air in the process, now we must be careful here because baby should be able to cope when they have proper functionality in their body.

3. Suboptimal Feeding Positions

Feeding a baby in a way that does not allow them to use their body properly to support their feeding can cause reflux when there may be nothing else wrong. I've worked with clients who, through use of common feeding practices have been unintentionally making reflux worse rather than better. So having the right position for your baby to feed effectively is vital.

4. Crying

Crying itself can lead to aerophagia, as babies swallow air when they cry for extended periods, regardless of why baby is crying. I've actually worked with a baby whose true underlying cause of reflux was over tiredness that then caused crying which resulted in reflux. This baby was unnecessarily medicated for months, when all that was needed was a calm return to their routine.

5. Use of Pacifiers

Frequent or aggressive use of pacifiers / dummies may contribute to air swallowing, particularly if the baby’s latch isn’t secure.

6. Oral Dysfunction

Issues such as muscular tension, tongue ties, lip ties, or other oral motor challenges can make it difficult for a baby to feed efficiently, increasing the likelihood of swallowing air.

7. Laughing

While laughing is a joyful and healthy behaviour, it can sometimes cause a baby to swallow small amounts of air. This is a natural occurrence and not something to discourage.

7. Flat head / Structural Misalignments

The structure of baby's head must be properly aligned to allow all the muscles involved in feeding to work together effectively. If there is misalignment or tension in one part, the rest are affected, just like if you injure your left hamstring, it affects how you walk with your right leg.

How Does Aerophagia Worsen Reflux?

Aerophagia plays a direct role in intensifying reflux symptoms. Excess air in the stomach creates pressure, forcing stomach contents upward into the oesophagus. This can:

• Increase Spitting Up: More air means more force pushing milk and stomach acid back up.
• Cause Pain and Discomfort: The presence of stomach acid in the oesophagus causes a burning sensation, which can be incredibly painful. Additionally air that makes it through the stomach into the intestines can become trapped, and cal lead to painful bloating and gas, making your baby even more fussy and unsettled.
• Heighten Risk of Aspiration: In some cases, stomach contents pushed upward can enter the airway, posing risks of aspiration and respiratory issues.

Signs Your Baby Might Have Aerophagia

Identifying aerophagia isn’t always straightforward, as its symptoms often overlap with general reflux indicators. Look out for these signs, although it must be said that one of none of these are directly indicative 

• Burping. This is the release of air from the stomach. 
• Hiccupping is also a way for the body attempting to regulate air in the digestive system.
• Spilling milk from the side of their mouth while they feed.

The greatest challenge is that we don't have many "specific" symptoms in anything reflux-related. We must actually look at the combination of symptoms. For example, vomiting isn't a reflux-only symptom, it can happen with air intake, with allergies, with fever, with over eating... And so we cannot say that just because a baby is spitting up that they are consuming excess air.

Showing you how to combine the patterns of signs and behaviours your baby has is my zone of genius, and what I do best, and teach you this as the first and fastest way to the right answer for your baby in the Reflux-Free Framework.

How to Address Aerophagia in Babies with Reflux

The first step is to confirm that your baby actually has Aerophagia. If their reflux is caused by an allergy or stress, then reducing their air intake won't actually help.

The next step is then to ask What is Causing This Aerophagia? Because if they are oral ties, they will need oral play support and possibly a tongue tie release (only if necessary). Or it could be structural misalignments, again, changing the dummy (pacifier) in this case might not help.

Addressing any cause of reflux and the root will always be the fastest way to an answer. And you can get help through the Reflux-Free Framework or The Baby Reflux Lady's Survival Guide.

The Bigger Picture: Aerophagia as Part of the Reflux Puzzle

Aerophagia is just one of many factors that can contribute to reflux in babies. While addressing air swallowing can provide significant relief, it’s essential to take a holistic approach to your baby’s reflux. This means considering all possible causes—from food intolerances and allergies to structural issues like tongue ties or laryngomalacia—to create a tailored plan that resolves your baby’s unique symptoms.

Why Identifying the Root Cause Matters

Aerophagia is often a symptom of broader feeding challenges, not an isolated issue. By focusing on the root cause rather than temporary fixes, you can help your baby find lasting relief. This approach not only improves their comfort now but also supports their long-term health and development.

What’s Next?

If this blog resonates with your experience, explore related topics:

• B is for Burping: The Myths and Truths About Relieving Baby’s Discomfort [coming soon]
• C is for Causes: How to Identify What’s Triggering Your Baby’s Reflux [coming soon]
• E is for Erosive Esophagitis: Recognising and Preventing Damage [coming soon]

By understanding aerophagia and its role in reflux, you’re taking the first step toward supporting your baby’s comfort and health. Remember, every baby is unique, and their journey to being reflux-free starts with identifying what’s causing their discomfort.

Would you like guidance tailored to your baby’s reflux? Learn more about my holistic Reflux-Free Framework here.