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Gastroesophageal Reflux Disease In Infants


What is gastroesophageal reflux disease?

Gastroesophageal reflux occurs when food, liquid, or acid from your baby's stomach backs up into his or her esophagus. Reflux is common in babies. It usually gets better within about a year as your baby's upper digestive tract matures. Gastroesophageal reflux disease (GERD) causes other symptoms that can lead to other problems such as poor weight gain.

What causes GERD?

GERD occurs when the lower muscle (sphincter) of your baby's esophagus does not close properly. The sphincter normally opens to let food into the stomach. It then closes to keep food and stomach acid in the stomach. If the sphincter is not full fully developed or does not close properly, food and stomach acid may back up (reflux) into the esophagus. The following may increase your baby's risk for GERD:

  • Neurological disorders such as cerebral palsy
  • Premature birth
  • Parents with GERD
  • Hiatal hernia
  • Exposure to secondhand smoke

What are the signs and symptoms of GERD?

The most common symptom is frequent spitting up or vomiting after feedings. Symptoms may be worse if you lay your baby down to sleep or you put him or her in a car seat after a feeding. Your baby may also have any of the following:

  • Irritability or constant crying after eating
  • Wet burps or hiccups
  • Wheezing
  • Dry cough or hoarseness
  • Gagging or choking while eating
  • Poor feeding and growth
  • Back arching during feedings

How is GERD diagnosed?

Your baby's healthcare provider will examine your baby. He or she will ask about your baby's symptoms and when they started. Tell the healthcare provider about your baby's feeding habits and any medical conditions. Your baby may need any of the following:

  • Upper GI x-rays are done to take pictures of your baby's stomach and intestines (bowel). Your baby may be given a chalky liquid to drink before the pictures are taken. This liquid helps his or her stomach and intestines show up better on the x-rays.
  • An endoscopy is a procedure used to look at the inside of your baby's esophagus and stomach. An endoscope is a bendable tube with a light and camera on the end. The healthcare provider may remove a small sample of tissue and send it to a lab for tests.
  • Esophageal pH monitoring is used to place a small probe inside your baby's esophagus and stomach to check the amount of acid.

How is GERD treated?

The goal of treatment is to relieve your baby's symptoms and prevent damage to his or her esophagus. Treatment also helps promote healthy weight gain and growth. Your baby may need any of the following:

  • Medicines are used to decrease stomach acid. Medicine may also be used to help your baby's lower esophageal sphincter and stomach contract (tighten) more.
  • Surgery is done to wrap the upper part of the stomach around the esophageal sphincter. This will strengthen the sphincter and prevent reflux.

What can I do to help manage my baby's GERD?

  • Feed your infant thickened formula. Thickening your baby's formula with rice cereal or special thickeners may help decrease symptoms. Ask your healthcare provider how you should thicken the formula. It may also be helpful to hold your baby upright after feedings. Your healthcare provider may also recommend small, frequent feedings to help decrease your baby's symptoms.
  • Keep a diary of your baby's symptoms. Bring the diary to visits with your baby's healthcare provider. The diary may help the provider plan the best treatment for him or her.
  • Keep your baby away from cigarette smoke. Do not smoke or allow others to smoke around your baby.

When should I call 911?

  • Your baby suddenly stops breathing, begins choking, or his or her body becomes stiff or limp.

When should I seek immediate care?

  • Your baby has forceful vomiting.
  • Your baby's vomit is green or yellow, or has blood in it.
  • Your baby has blood in his or her bowel movements.
  • Your baby suddenly has trouble breathing or wheezes.
  • Your baby's stomach is swollen.

When should I contact my baby's healthcare provider?

  • Your baby becomes more irritable or fussy and does not want to eat.
  • Your baby becomes weak and urinates less than normal.
  • Your baby is losing weight.
  • You have questions or concerns about your baby's condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.