Health Library

Gastroesophageal Reflux in Infants

Most infants with gastroesophageal reflux are happy and healthy even though they spit up or vomit. An infant with gastroesophageal reflux may experience:

• Spitting
• Vomiting
• Coughing
• Irritability
• Poor feeding
• Discomfort with feeding

How Common Is Gastroesophageal Reflux in Babies?

Gastroesophageal reflux happens often in healthy infants. More than half of all babies have reflux in the first 5 months of life.

Only a small number of infants have problems from gastroesophageal reflux. Most infants stop spitting up between the ages of 12 to 18 months.

What Causes Gastroesophageal Reflux in Babies?

There is a ring of muscle at the bottom of the esophagus that opens and closes, allowing food to enter the stomach. This ring of muscle is called the lower esophageal sphincter (LES).

In infants, this sphincter is not as strong as that in older children and adults. The sphincter easily opens and the stomach contents often go up the esophagus and out the mouth (spitting up or vomiting).

Gastroesophageal reflux disease can also happen when babies cough, cry or strain as the pressure in their stomachs increases at these times.

What Are the Signs and Symptoms of Gastroesophageal Reflux in Babies?

In a small number of babies, gastroesophageal reflux can cause concerning symptoms like:

• Poor growth because they cannot hold down enough food
• Irritability or refusing to eat because of pain
• Blood loss from acid burning the esophagus
• Breathing problems

But these problems can also be caused by disorders other than gastroesophageal reflux. Your healthcare provider needs to determine if gastroesophageal reflux is causing your child's symptoms.

How Is Gastroesophageal Reflux Diagnosed in Babies?

An infant who spits up or vomits may have gastroesophageal reflux. The doctor or nurse will talk with you about your child's symptoms and perform a physical examination. If the infant is healthy, happy and growing well, no treatment or testing may be needed.

Sometimes, tests may be ordered to help determine if your child's symptoms are related to gastroesophageal reflux. Often, treatment is started without the need for any tests.

How Is Gastroesophageal Reflux Treated in Babies?

The treatment of reflux depends upon the infant's symptoms and age. Some babies may not need any treatment, as gastroesophageal reflux will usually get better without treatment. Healthy, happy babies may only need to be kept upright after they are fed.

Overfeeding can make reflux worse, and your healthcare provider may suggest a different feeding schedule. For example, smaller amounts of food with more frequent feedings can help decrease the chances of reflux.

If a food allergy is suspected, your healthcare provider may ask you to change the baby's formula or modify the mother's diet if the baby is breastfed. If a child is not growing well, feedings with higher calorie content or tube feedings may be recommended.

If your child is uncomfortable, or has difficulty sleeping, eating or growing, the doctor may suggest a medication. Different types of medicine can be used to treat reflux by decreasing the acid in the stomach.

Although these medications will help protect your child's esophagus from damage due to reflux, the medicines are unlikely to completely cure the spitting up.

Very rarely do infants have severe gastroesophageal reflux that prevents them from growing or that causes breathing problems. It is rare for infants to need surgery for gastroesophageal reflux. If surgery is necessary, your baby's doctor or nurse can discuss treatment options with you.