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Gastroesophageal reflux in infants

Does your baby spit up all the time? Is he crying inconsolably and you can't figure out why? Your baby may have gastroesophageal reflux. When a baby eats, food passes from their throat to their stomach through the esophagus, also called the food pipe. Once food is in the stomach, a ring of muscle prevents food from moving backwards into the esophagus. If this muscle doesn't close well, food can leak back into the esophagus. This is called gastroesophageal reflux. If the reflux is causing problems, it's called GERD. How do you know for sure that your baby has GERD? Some reflux in infants after a meal is normal. Most will have reflux during their first three months of life because the ring of muscle, or sphincter, preventing food from moving back into their esophagus hasn't toughened up yet. The time to be concerned is if your baby is fussy a lot, has a chronic cough or chronic ear infections, does not eat well, or doesn't gain as much weight as he should. When GERD lasts beyond about 18 months, your child's doctor will probably want to run some tests, including pH probes, to find out how often and how long stomach acid is in your child's esophagus, gastric emptying studies, and x-rays. So, how is GERD in infants treated? Changing how you feed your baby can go a long way toward helping his reflux. Try burping your baby after he drinks one to two ounces of formula, or after feeding on each side if you are breastfeeding. You can add a tablespoon of rice to two ounces of formula, cow's milk (for baby's 12 months or older), or pumped breast milk. Changing the size of the nipple for your baby's bottle may help. Try holding your baby upright for 20 to 30 minutes after feeding too. Avoid overfeeding and avoid exposure to tobacco smoke. For some babies, avoiding cow's milk protein may also help. If reflux is still causing problems, your baby's doctor may try medications. Most babies outgrow this problem. But rarely GERD may last into childhood, potentially causing damage to their esophagus. Your child's doctor will keep an eye on the problem and let you know if surgery to fix it is a good idea.

Gastroesophageal reflux in infants

Review Date: 5/20/2019

Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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