GERD in Infants and Children

From diaper blowouts to snotty noses, caring for an infant can desensitize even the most squeamish person to many bodily functions.

The most conspicuous bodily function in infants might be spitting up. Anyone who has spent any time around an infant has most likely seen them spit up. Luckily, infant reflux is common and rarely a cause for concern.

But in the rare case that more worrisome symptoms like weight loss or failure to thrive also happen, a larger problem might be at play. An infant could have a blockage in the digestive system, an allergy, or gastroesophageal reflux disease (GERD).

What Is GERD?

GERD occurs when a muscle at the end of your esophagus — the tube that carries food from your mouth to your stomach — does not close right. When this happens, stomach contents can leak back into the esophagus, causing irritation.

You should get your baby checked for GERD if their reflux prevents them from feeding or if the reflux lasts past 12 to 14 months of age.

How Do I Know if My Baby Has GERD?

Reflux is common in babies and infants because the muscle at the end of the esophagus is not developed all the way. Once that muscle develops, around 12 to 14 months, reflux should rarely happen.

Babies who have GERD have a weak or relaxed esophageal sphincter muscle that relaxes when it shouldn’t. GERD is very common among young infants. But by the time they turn 1, only about 10% of babies still have GERD, according to the National Library of Medicine.

Infants are more likely to have GERD if they have certain health conditions, including:

  • Premature birth.
  • Lung conditions (such as cystic fibrosis).
  • Nervous system conditions (such as cerebral palsy).
  • Previous surgery to correct esophageal atresia. This is a birth defect in which part of a baby’s esophagus does not develop properly.

Symptoms of GERD in Infants

Of course, the main symptom of GERD in babies is spitting up. Heartburn, or burning in the chest or throat, is a symptom of reflux and GERD.

Children and adults can usually verbalize if they are experiencing heartburn. But for infants, it is important to watch out for physical signs of heartburn. Right after eating, a baby may arch their back or have abnormal movements of the neck and chin.

Other symptoms to watch out for include:

  • Choking or gagging.
  • Problems swallowing.
  • Loss of appetite or refusing to eat.
  • Coughing or wheezing.
  • Trouble gaining weight.

How to Treat GERD in Infants

Often, GERD symptoms improve on their own and do not need treatment. But depending on your baby’s age, their pediatrician might recommend diet changes to ease the symptoms. Do not make changes to your baby’s diet without first consulting their pediatrician.

Diet and feeding changes

Diet and feeding changes your pediatrician may recommend to reduce symptoms of GERD can include:

  • More frequent burping. For parents who use formula, this may be after every 1 to 2 ounces. For breastfeeding mothers, it may be after nursing from each breast.
  • Thickening your infant’s food. Your pediatrician may recommend adding rice cereal or stored breast milk to formula.
  • Switching to a specialized formula.

Medical treatments for GERD

If you have already tried diet changes and your baby still is having issues with growth, weight gain, or trouble sleeping or feeding, your pediatrician may prescribe medicine that decreases acid production.

Rarely, doctors treat GERD with surgery in babies who have severe breathing problems or who have a physical problem that causes their symptoms.

GERD in Adults and Children

Infants aren’t the only ones who can suffer from GERD. Adults and children who have reflux more than twice per week should get checked for GERD.

Other symptoms of GERD in adults and children include:

  • Heartburn (more common in adults and children older than 12).
  • Bad breath.
  • Problems or pain while swallowing.
  • Nausea and vomiting.

Like infants, most treatments for GERD in adults and children are diet-related. Treatments include:

  • Avoiding spicy, fatty, or acidic foods that cause heartburn.
  • Avoiding alcohol (adults).
  • Avoiding overeating.
  • Losing weight if necessary.
  • Avoiding eating close to bedtime.
  • Wearing loose clothing.
  • Over-the-counter antacids.

UPMC Children’s Hospital of Pittsburgh’s Pediatric Aerodigestive Center treats a wide range of digestive conditions in children, including GERD. For more information or to schedule an appointment, visit our website.


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