Gastroesophageal reflux is a condition in which stomach contents travels backward from the stomach to the esophagus, rather than down through the digestive system. This article discusses reflux in infants.

Reflux - infants

In infants, a small amount of gastroesophageal reflux is normal. Persistent reflux with frequent vomiting leads to irritation of the esophagus and fussiness in the infant. Reflux associated with weight loss or reflux that causes breathing difficulty is considered abnormal.

• Chronic cough
• Excessive crying as if in pain
• Excessive vomiting during the first few weeks of life
• Extremely forceful vomiting
• No breathing or breath-holding spells
• Slow growth
• Weight loss
• Wheezing

The health care provider can often make the diagnosis based on the patient's symptoms and physical examination.

Tests that may be done include:

• Esophageal pH monitoring to determine how often and for how long stomach acid enters the esophagus
• X-ray of the esophagus
• X-ray of the upper gastrointestinal system after the baby has been given a special liquid, called contrast, to drink

If your baby has reflux problems, hold the baby upright for 20-30 minutes after feeding. Raise the head of the crib, if possible.

When the infant begins to eat solid food, thickened foods may help.

Sometimes medicines are used to reduce acid or increase the movement of the intestines.

The majority of infants outgrow this condition. In unusual cases, reflux may persist into childhood and can cause varying degrees of esophageal damage.

• Aspiration pneumonia caused by stomach contents passing into the lungs
• Irritation and swelling of the esophagus
• Scarring and narrowing of the esophagus

Call your health care provider if your baby is vomiting frequently, especially if the vomiting is forceful or if other symptoms of reflux occur.

Orenstein S, Peters J, Khan S, Youssef N, Hussain SZ. Gastroesophageal reflux disease (GERD). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 320.