Learn About Gastroesophageal Reflux in Infants
Gastroesophageal reflux occurs when stomach contents leak backward from the stomach into the esophagus. This causes "spitting up" in infants.
Reflux - infants
When a person eats, food passes from the throat to the stomach through the esophagus. The esophagus is called the food pipe or swallowing tube.
A ring of muscle fibers prevents food at the top of the stomach from moving up into the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES. If this muscle does not close well, food can leak back into the esophagus. This is called gastroesophageal reflux.
A small amount of gastroesophageal reflux is normal in young infants. However, ongoing reflux with frequent vomiting can irritate the esophagus and make the infant fussy. Severe reflux that causes weight loss or breathing problems is not normal.
Symptoms may include:
- Cough, especially after eating
- Excessive crying as if in pain
- Excessive vomiting during the first few weeks of life; worse after eating
- Extremely forceful vomiting
- Not feeding well
- Refusing to eat
- Slow growth
- Weight loss
- Wheezing or other breathing problems
Often, no feeding changes are needed for infants who spit up but are growing well and seem otherwise content.
Your provider may suggest simple changes to help the symptoms such as:
- Burp the baby after drinking 1 to 2 ounces (30 to 60 milliliters) of formula, or after feeding on each side if breastfeeding.
- Add 1 tablespoon (2.5 grams) of rice cereal to 2 ounces (60 milliliters) of formula, milk, or expressed breast milk. If needed, change the nipple size or cut a small x in the nipple.
- Hold the baby upright for 20 to 30 minutes after feeding.
- Raise the head of the crib. However, your infant should still sleep on the back, unless your provider suggests otherwise.
When the infant begins to eat solid food, feeding thickened foods may help.
Medicines can be used to reduce acid or increase the movement of the intestines.
Annamaria Staiano practices in Naples, Italy. Ms. Staiano is rated as an Elite expert by MediFind in the treatment of Gastroesophageal Reflux in Infants. Her top areas of expertise are Gastroesophageal Reflux in Infants, Viral Gastroenteritis, Chronic Idiopathic Constipation (CIC), Ileostomy, and Endoscopy.
Universitair Ziekenhuis Brussel
Yvan Vandenplas practices in Brussels, Belgium. Mr. Vandenplas is rated as an Elite expert by MediFind in the treatment of Gastroesophageal Reflux in Infants. His top areas of expertise are Gastroesophageal Reflux in Infants, Gastroesophageal Reflux Disease (GERD), Diarrhea, Grass Allergy, and Endoscopy.
Marc Benninga practices in Amsterdam, Netherlands. Mr. Benninga is rated as an Elite expert by MediFind in the treatment of Gastroesophageal Reflux in Infants. His top areas of expertise are Chronic Idiopathic Constipation (CIC), Gastroesophageal Reflux in Infants, Gastroesophageal Reflux Disease (GERD), Sacral Nerve Stimulation, and Endoscopy.
Most infants outgrow this condition. Rarely, reflux continues into childhood and causes esophageal damage.
Complications may include:
- Aspiration pneumonia caused by stomach contents passing into the lungs
- Irritation and swelling of the esophagus
- Scarring and narrowing of the esophagus
Contact your provider if your baby:
- Is vomiting forcefully and often
- Has other symptoms of reflux
- Has problems breathing after vomiting
- Is refusing food and losing or not gaining weight
- Is crying often
Summary: Infants often experience functional gastrointestinal symptoms (e.g., colic, excessive gas, regurgitation, constipation, or loose stools) that distress families and may reflect an imbalance of the gut microbiome. This study evaluates whether the multistrain probiotic BioAmicus Complete can improve caregiver-reported gastrointestinal symptoms in infants 0-24 months and is safe for use in this popula...
Summary: Gastroesophageal reflux disease in infants is not fully understood. Infants are prescribed medical treatments that may not be effective or that contribute to adverse side effects and lead to concerns and expenses for the parents and healthcare system. Current guidelines recommend cow-milk-protein free diet as a first-line treatment, but these recommendations are based on weak evidence. This study ...
Published Date: August 05, 2023
Published By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Hibs AM. Gastrointestinal reflux and motility in the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 82.
Khan S, Matta SKR. Gastroesophageal reflux disease. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 349.