Gastroesophageal Reflux Disease (GERD) in Infants
GERD stands for gastroesophageal reflux disease. You may also hear it called acid indigestion or heartburn. It happens when food from the stomach flows back up (refluxes) into the tube that connects the mouth to the stomach (esophagus). Regurgitating or spitting up is common in infants. This is called gastroesophageal reflux or GER. In fact, more than half of babies have GER during their first 3 months. Babies with GER will often spit up after being fed. They may sometime spit up when coughing or crying. They may also be fussy during or after feeding. Babies often grow out of GER when they are about 12 to 18 months old. But if GER does not go away as your baby grows, or if damage occurs to the esophagus, such as inflammation or narrowing, the baby may have GERD.
Is GERD a problem for my baby?
If a baby is happy and gaining weight normally, the regurgitation is probably GER and is likely not causing harm. But certain symptoms can be signs of GERD, a more serious problem. Tell your healthcare provider if your baby has any of the following symptoms:
Blood, or green or yellow fluid in vomit
Poor weight gain or growth
Continues to refuse to eat
Trouble eating or swallowing
Breathing problems such as wheezing, persistent cough, or trouble breathing
Waking up at night coughing or wheezing
How can I help my child feel better?
Your baby will likely outgrow GER. To help reduce GER and spitting up in the meantime, the following changes can help:
Feed your baby smaller meals more often. Don’t feed your baby again if he or she spits up. Wait until the next mealtime.
Feed your baby in an upright position.
Burp your baby gently after each breast, or after 1 to 2 ounces of a bottle.
Keep your baby in a seated or upright position for at least 30 minutes after meals.
For bottle-fed babies, ask your doctor about thickening the breastmilk or formula.
Avoid tight waistbands and diapers.
Keep tobacco smoke away from your baby.
It is not known if these measures can prevent GER from progressing to GERD, but they are helpful for both conditions.
When should my child see the doctor?
If your child has more serious symptoms of GERD, your baby's doctor or nurse will work with you to help relieve them. Your healthcare provider may suggest some changes in addition to the ones above. These may include raising the head of the crib or trying different formula. Medicines are sometimes prescribed. In certain cases, your baby may need tests to help be sure of the cause of the symptoms.
September 29, 2017
Gastroesophageal reflux in infants, Up To Date, Lightdale, JR., Gastroesophageal Reflux: Management Guidance for the Pediatrician, Pediatrics (2013); 131(5); e1685-e1695
Freeborn, Donna, PhD, CNM, FNP,Image reviewed by StayWell art team.,Lehrer, Jenifer, MD