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Gastroesophageal Reflux Disease (GERD) in a Baby

Gastroesophageal reflux (GER) is when gas or liquid from the stomach comes up the esophagus. It can cause babies to spit up. All babies have reflux from time to time. This is because in babies the muscle that opens and closes the top of the stomach is very relaxed. It opens easily. Gas and fluid tend to escape.

Babies with severe reflux have gastroesophageal reflux disease (GERD). A baby with GERD may spit up too much. They may not get enough nourishment from food. A baby can also aspirate (breathe in) spit-up liquid. This can cause problems with your baby’s breathing.

When does GERD need treatment?

Reflux is treated if your baby has any of these:

  • Breathing that stops for 20 seconds or more at a time (apnea)

  • Noisy breathing

  • Pneumonia that comes back

  • Not enough growth

  • Pain (irritable or fussy) when spitting up

  • Bloody vomit

  • Blood in their poop

How is GERD treated?

Woman holding baby upright in lap.
Keeping a baby up after feeding helps keep fluid from traveling up from the stomach.

  • Feeding changes. You may need to feed smaller amounts more often. You may need to burp them more often during feedings. Letting more time pass between feedings may help. You may need to stop drinking milk or eating dairy foods if you are breastfeeding. You may need to give your baby a special formula if you are not breastfeeding.

  • Positioning therapy. Keep your baby upright after feeding. For 20 to 30 minutes after feeding, put your baby so that their head is higher than their stomach. Do this by carrying your baby in an upright position. For example, put the baby over your shoulder. Don't place your baby in a baby carrier or car seat. (When it’s time for sleep, put your baby on their back on a flat, firm surface. This is to help prevent SIDS (sudden infant death syndrome).)

  • Medicines. This may include medicines to lower the amount of acid in the stomach. This keeps the stomach acids from harming the esophagus. Other medicines may be used to speed up digestion. This is so food passes out of the stomach quicker.

  • Surgery. In severe cases, surgery may be done. It makes the valve at the top of the stomach stronger. It does this by wrapping part of the stomach around the esophagus. When the stomach is relaxed and empty, food can pass through. When the stomach is full, pressure closes the valve.

What are the long-term effects?

In most cases, reflux gets better over time and causes no long-term problems.

Online Medical Reviewer: Donna Freeborn PhD CNM FNP
Online Medical Reviewer: Heather M Trevino BSN RNC
Online Medical Reviewer: Liora C Adler MD
Date Last Reviewed: 12/1/2021
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