Warm or Cold Formula for Infant Reflux? 6 Feeding Tips

| Reviewed By Sarah Schulze, MSN, APRN, CPNP

Infant reflux is common among young babies with developing digestive systems. While warm formula may be soothing for babies with reflux, you may also be able to relieve your child’s tummy trouble with cold formula.

Does warm formula help with reflux? No, warm formula doesn’t necessarily help with infant reflux. You can give your baby cold or warm formula based on their preference. How you prepare the formula, your baby’s age, and what happens during feedings can cause or relieve reflux.

In the following, you’ll learn more about the ideal temperature for formula and how to prevent reflux during feedings.

Baby Formula Temperature for Reflux

The temperature of your baby’s formula doesn’t necessarily cause or relieve digestive issues. Prepare for feedings based on your child’s preference.

Does Formula Temperature Matter for Reflux?

Formula temperature often depends on your baby’s preference. Many babies, both those with reflux and those who do not have it, prefer warm bottles, but some seem to do better when formula is given cool or cold.

Advantages of Warm Formula for Reflux

Warm formula is usually more comfortable for babies. Breastfed babies drink milk at body temperature, around 98.6 degrees Fahrenheit.

If breastfeeding isn’t an option for you, you can give your baby warm formula to mimic the feeling of breastfeeding.

Boiling tap water before mixing it with formula kills any bacteria that could be harmful to immunocompromised babies. Just make sure to let it cool properly before using it to make bottles.

Why Some Babies Prefer Cool Formula for Reflux

Some babies like to drink cold formula because it may be soothing for their developing teeth.

Cold formula is easier to prepare, allowing your baby to get their food immediately instead of waiting for it to warm. It’s also more convenient to bring a cold bottle around as you travel with your baby.

While some babies seem to have some relief from reflux when given cold formula, this isn’t the case for all babies.

Ideal Baby Formula Temperature

The ideal baby formula temperature is about body temperature, or 98.6 degrees Fahrenheit. You can warm up a bottle in a programmable bottle warmer, on the stove, or under the faucet. Microwaves may heat fluid unevenly and should not be used.

After bringing the water to the right temperature, swirl its contents to distribute the heat evenly. You may also want to drip a little of the milk onto your wrist to test if it’s too warm.

A woman testing baby bottle temperature by dropping some milk on her wrist.

When Does Reflux Peak in Babies?

Reflux in infants occurs for a combination of reasons. The primary reason is that they have a weak lower esophageal sphincter (LES), or the muscle between their throat and stomach.

This muscle typically only opens in adults when we swallow food, but it is less developed in infants and may open randomly, particularly if an infant’s stomach is full, and allow the contents to come right back up. The all-liquid diet of young infants paired with the fact that they spend a lot of their time lying flat also increases the ease with which spit-up occurs.

Reflux peaks when a baby’s diet mostly consists of milk, from 2 to 3 weeks to about 4 to 5 months. Starting solids may help reduce reflux, but most babies stop spitting up after feeding by their first birthday.

Consult your child’s pediatrician if your child doesn’t stop experiencing reflux after two years.

How To Soothe Baby Acid Reflux – 7 Tips

If your baby spits up or acts fussy after a feeding, follow these seven tips to relieve their symptoms.

1. Use a Bottle Warmer

Heat your baby’s bottle with a bottle warmer instead of hot water on a stove top or from the faucet. This bottle warmer comes highly recommended and can serve a double purpose as a baby food warmer when your child progresses to solid foods.

This programmable baby product will get the milk to your desired temperature quickly and easily, leaving you with more time to be with your baby.

2. Keep Baby Upright Before & After Feeding

Sitting a baby upright is the proper position for feeding. You should also keep them upright for about 30 minutes after a feeding. Use this time to read a book, snuggle, or sing to your baby.

Change their diaper before a feeding to keep them off their back after eating. Also, try not to put them to bed right after a feeding.

3. Offer Smaller Amounts More Frequently

A full stomach puts pressure on the lower esophageal sphincter (LES), the muscle between the stomach and the esophagus, which keeps food from coming back up.

Offer smaller amounts more frequently to keep pressure off the LES and ease digestion.

4. Use a Slow-Flow Nipple

Babies spit up when they drink too much milk too quickly. Help them learn to control their milk intake by using a slow-flow nipple or a bottle made for preventing colic. For younger babies, it also helps to use a smaller nipple.

5. Burp Baby Several Times During Feeding

Since babies take in a lot of air while feeding through a bottle, try burping your baby several times during and after a feeding. Burp your bottle-fed baby once after they drink about an ounce of milk and then again after they’ve finished.

6. Ask Your Pediatrician About Medications

If nothing else eases your child’s reflux, their pediatrician can help. You may want to consider medication if your child isn’t gaining weight. Medications should only be a last resort and under the guidance of your child’s doctor.

7. Ask Doctor About Adding Cereal to Bottle

In place of medication, your child’s pediatrician may also recommend adding rice cereal to formula to thicken it. The heavier formula can stay longer in your child’s stomach.

However, there isn’t enough evidence that adding cereal to the bottle eases all reflux symptoms. Check with your child’s pediatrician to help with your child’s specific needs.

Signs of Severe Infant Reflux

In an otherwise happy and growing baby, spitting up after feedings is not cause for concern. While normal infant reflux typically causes fussiness and spit-up, call your child’s doctor if you notice the following symptoms of severe reflux in infants:

  • Weight loss issues
  • Green, yellow, red, or brown spit up
  • Wheezing or gurgling during or after a feeding
  • Gritty or bloody stools
  • Refusing food at feedings
  • Inconsolable crying from pain
  • Slow heartbeat
  • Difficulty breathing

Best Formula for Acid Reflux

Talk to your child’s pediatrician before switching formulas. Most formula products contain cow’s milk fortified with essential vitamins. Some babies have difficulty digesting the cow’s milk protein. 

Try these products to help ease reflux:

  • Hydrolyzed protein: This formula also contains cow’s milk protein but has added ingredients to relieve digestion issues. If your child has food allergies, the pediatrician may recommend trying this for a few weeks to see if symptoms are alleviated.
  • Soy milk: Since this formula doesn’t have any cow’s milk, your child should only have it if they have an intolerance to lactose or galactose, both found in cow’s milk. Soy milk formula may affect bone development and create hormonal imbalances in young children.
  • Amino Acid Formula: This formula is made without the use of cow’s milk protein or soy and can provide adequate nutrition for infants who need to avoid the protein altogether. 
  • Specialized formula: Check with your child’s pediatrician about formula made especially for babies with specific medical conditions, such as premature birth.

Related Questions:

What Causes Infant Reflux?

Infant reflux is caused by an underdeveloped lower esophageal sphincter (LES), the muscle connecting the esophagus to the stomach.

A full stomach presses on this weak muscle and brings the food or milk back through the mouth. Reflux is more likely when a baby eats too much or too quickly.

When Does Reflux Stop in Babies?

Reflux usually peaks in babies at around 4 months and stops between ages 12 to 18 months.

Babies who have reflux past age 2 may have GERD (gastroesophageal reflux disease). In that case, you should consult your child’s pediatrician about how to get the best treatment.


Infant reflux may be unsettling, but it’s actually quite normal for babies to experience.

Whether your child prefers warm or cold milk, ease their tummy troubles with slow-flow nipples on their bottles and hold them upright during feedings.