Many people think that gastroesophageal reflux (GERD) is a problem for adult, especially older adults. But reflux is actually a very common problem for infants too – and it can be a very distressing one for parents and babies both.  However, the good news is that if you are able to identify signs and symptoms of GERD, understand why it is happening and know what to do to treat it, you can get your child through this difficult stage in their development.

Know the Signs

Most babies spit up in the first year of their lives and this is not considered to be a sign of GERD.  However, if your baby has any of the following symptoms – especially if they go on for a long time – then you should definitely talk to your doctor about your concerns.  These signs include:

Throwing up frequently after feedings. This can happen several times a day and go on for weeks or months if left untreated

Being fussy or colicky during or after feedings

Refusing to feed or feeding poorly

Failing to gain weight or slowed growth/development

Don’t hesitate to call your doctor if you have noticed any of these signs. Your doctor can run tests to see if there is a problem and then come up with a game plan to treat it.

Understand the “Why”

If you understand the reasons that lie behind GERD, it might help you to feel less stressed. The most important thing to know is that in the vast majority of cases, GERD is not serious and will not lead to permanent damage of the esophagus (throat).  Usually, the cause is that of an immature digestive system and a pyloric valve that does not always shut when it is supposed to, letting the contents of the baby’s stomach back up into their throat and mouths.  

The immaturity of a baby’s digestive system is not the only problem.  GERD also happens because of a combination of number of risk factors that are hard to do anything about, including the fact that babies spend a lot of time lying on their backs and also that their diet is made up of liquids (which makes it easier to back up into the throat) and their digestive systems are immature and sometimes uncoordinated.  There is also a genetic component to this problem and it is one which tends to run in families.

The great news is that almost all infants outgrow this as they mature and symptoms will usually go away on their own by age 18 months.  It is estimated that only about 5% of babies with GERD will continue to have this condition as toddlers.

Come up with a Game Plan

If your baby is diagnosed with GERD, don’t worry. You and your doctor can sit down and come up with a game plan to help treat it until your baby grows out of it and his digestive system fully develops.  Much of this game plan will consist of minor lifest‌yle changes you can make as a parent, but sometimes medications or even surgery will be necessary.

Treatment can include any of the following:

Feeding your baby less breastmilk or formula at a time (but more frequently, so they are still getting the calories that they need for healthy growth and development)

Talking to your doctor about thickening your breastmilk or formula with something like a rice cereal, to make reflux less likely.

Burping your baby between and after feedings.

Elevating the head of your baby’s crib or bassinette so that food is less likely to flow backwards into the throat and mouth.

Keeping your baby upright for around half an hour after feeding.

Talking to your doctor about starting your baby on solid foods if he is old enough (this may or may not be a good option and it is not one you should try without consulting with your doctor ahead of time).

Trying medications on your baby if the lifest‌yle changes above are not helping. Choices can include antacids like Mylanta or more powerful medications like ranitidine or omeprazole.

Undergoing surgery on the pyloric sphincter if medications and the lifest‌yle changes listed above do not produce results.

Things to Keep in Mind

There are a few things to keep in mind about GERD, however.

First, it is important to report worrying signs and symptoms to the doctor because it can sometimes mask other issues that you need to know about, such as an allergy to milk (or other food allergy) or a condition called pyloric stenosis, where the pyloric sphincter above your baby’s stomach has become narrowed and won’t allow food to pass into the stomach.   Second, it is also good to be aware of other more serious signs and symptoms that should be reported right away are the vomiting of green, yellow or coffee ground-like substances, projectile vomit or failure to gain weight.

The good news is, however, that in most cases babies will outgrow this problem as they mature and develop and that the simple lifest‌yle changes listed above are enough to take care of the problem in the meantime.