What is infant reflux?
Infant reflux occurs when food backs up (refluxes) from a baby’s stomach, causing the baby to spit up. Sometimes called gastroesophageal reflux (GER), the condition is rarely serious and becomes less common as a baby gets older. It’s unusual for infant reflux to continue after age 18 months.
Reflux occurs in healthy infants multiple times a day. As long as your baby is healthy, content and growing well, the reflux is not a cause for concern.
Rarely, infant reflux can be a sign of a medical problem, such as an allergy, a blockage in the digestive system or gastroesophageal reflux disease (GERD).
How common is infant reflux?
Reflux is very common in babies. About half all babies spit up many times a day in the first 3 months of their lives. They usually stop spitting up between the ages of 12 and 14 months. GERD is also common in younger infants. Many 4-month-olds have it. But by their first birthday, only 10 percent of babies still have GERD. Please discuss with your doctor for further information.
What are the symptoms of infant reflux?
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if your baby:
- Isn’t gaining weight
- Consistently spits up forcefully, causing stomach contents to shoot out of his or her mouth (projectile vomiting)
- Spits up green or yellow fluid
- Spits up blood or a material that looks like coffee grounds
- Refuses food
- Has blood in his or her stool
- Has difficulty breathing or a chronic cough
- Begins spitting up at age 6 months or older
- Is unusually irritable after eating
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes infant reflux?
There is a muscle (the lower esophageal sphincter) that acts as a valve between the esophagus and stomach. When your baby swallows, this muscle relaxes to let food pass from the esophagus to the stomach. This muscle normally stays closed, so the stomach contents don’t flow back into the esophagus.
In babies who have reflux, the lower esophageal sphincter muscle is not fully developed and lets the stomach contents back up the esophagus. This causes your baby to spit up (regurgitate). Once his or her sphincter muscle fully develops, your baby should no longer spit up.
In babies who have GERD, the sphincter muscle becomes weak or relaxes when it shouldn’t.
What increases my risk for infant reflux?
Please discuss with your doctor for further information.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is infant reflux diagnosed?
Your doctor will start with a physical exam and questions about your baby’s symptoms. If your baby is healthy, growing as expected and seems content, then further testing usually isn’t needed.
If further testing is needed, your doctor might recommend:
- This imaging test can detect pyloric stenosis.
- Lab tests. Blood and urine tests can help identify or rule out possible causes of recurring vomiting and poor weight gain.
- Esophageal pH monitoring. To measure the acidity in your baby’s esophagus, the doctor will insert a thin tube through the baby’s nose or mouth and into the esophagus. The tube is attached to a device that monitors acidity. Your baby might need to stay in the hospital while being monitored.
- X-rays. These images can detect abnormalities in the digestive tract, such as an obstruction. Your baby may be given a contrast liquid (barium) from a bottle before the test.
- Upper endoscopy. A special tube equipped with a camera lens and light (endoscope) is passed through your baby’s mouth and into the esophagus, stomach and first part of the small intestine. Tissue samples may be taken for analysis. For infants and children, endoscopy is usually done under general anesthesia.
How is infant reflux treated?
Infant reflux usually clears up by itself. In the meantime, your doctor might recommend:
- Giving your baby smaller, more-frequent feedings.
- Interrupting feedings to burp your baby.
- Holding your baby upright for 20 to 30 minutes after feedings.
- Eliminating dairy products, beef or eggs from your diet if you’re breast-feeding, to test if your baby has an allergy.
- Switching the type of formula you feed your baby.
- Using a different size of nipple on baby bottles. A nipple that is too large or too small can cause your baby to swallow air.
- Thickening formula or expressed breast milk slightly and in gradual increments with rice cereal. Although recognized as a reasonable strategy, thickening adds potentially unnecessary calories to your baby’s diet.
Reflux medications aren’t recommended for children with uncomplicated reflux. These medications can prevent absorption of calcium and iron, and increase the risk of certain intestinal and respiratory infections.
However, a short-term trial of an acid-blocking medication — such as ranitidine for infants age 1 month to 1 year or omeprazole (Prilosec) for children age 1 year or older — might be recommended if your baby:
- Has poor weight gain and more-conservative treatments haven’t worked
- Refuses to feed
- Has evidence of an inflamed esophagus
- Has chronic asthma and reflux
Rarely, the lower esophageal sphincter is surgically tightened to prevent acid from flowing back into the esophagus. This procedure (fundoplication) is usually done only when reflux is severe enough to prevent growth or to interfere with your baby’s breathing.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage infant reflux?
The following lifestyles and home remedies might help you cope with infant reflux:
- Feed your baby in an upright position. Also hold your baby in a sitting position for 30 minutes after feeding, if possible. Gravity can help stomach contents stay where they belong. Be careful not to jostle or jiggle your baby while the food is settling.
- Try smaller, more-frequent feedings. Feed your baby slightly less than usual if you’re bottle-feeding, or cut back a little on the amount of nursing time.
- Take time to burp your baby. Frequent burps during and after feeding can keep air from building up in your baby’s stomach.
- Put baby to sleep on his or her back. Most babies should be placed on their backs to sleep, even if they have reflux.
- Remember, infant reflux is usually little cause for concern. Just keep plenty of burp cloths handy as you ride it out.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Infant reflux. https://www.mayoclinic.org/diseases-conditions/infant-acid-reflux/symptoms-causes/syc-20351408. Accessed November 17, 2017.
Reflux in Infants. https://medlineplus.gov/refluxininfants.html. Accessed November 17, 2017.
Review Date: November 17, 2017 | Last Modified: November 17, 2017