Spitting Up Not Always Acid Reflux Disease

upset baby close up

Your baby spitting up after every meal can be scary. But it’s not necessarily a sign of gastroesophageal reflux disease (GERD) or that your baby needs testing, medications or other therapies, advises new guidelines from the North American Society for Pediatric Gastroenterology.

Concerned parents may think their baby has GERD if he regurgitates regularly after eating. But this is normal in more than two-thirds of otherwise healthy infants.

This condition is known as uncomplicated gastroesophageal reflux, or GER, and research shows that most infants outgrow it by about 1 year old. When complications arise from GER, it is then referred to as GERD.

Symptoms of GER

Uncomplicated acid reflux (GER) is marked by constant spitting up of meals and is sometimes accompanied by:

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  • Coughing
  • Hiccups
  • Vomiting
  • Irritability

While these symptoms may be worrisome, parents shouldn’t jump to the conclusion it’s more than GER.

When GER becomes GERD

Skyler Kalady, MD, did not take part in the society’s report, but is a pediatrician at Cleveland Clinic.

Dr. Kalady says the complications indicating that the baby may have GERD, or something more serious, include the symptoms of GER along with:

  • Poor weight gain
  • Pneumonia
  • Extreme irritability (from acid coming up in the esophagus)
  • Stomach ache
  • Sleep disturbances

If your baby has GER or GERD

The first-line therapy to relieve GER is to change positions while feeding, or give smaller but more frequent feeding. Nursing mothers should limit spicy and fatty foods, too.

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Medications are only to be used for treating GERD, especially when the baby is vomiting. Surgery is usually reserved for babies who are at risk for life-threatening complications.

Dr. Kalady thinks the society’s guidelines will help to distinguish infant reflux from more serious disorders to avoid unnecessary costs and treatments.

“If a baby has GER we can reassure families that they only need changes in feeding patterns, but likely not medications,” says Dr. Kalady. “Babies with GERD would benefit from feeding changes as well as medical drug therapy.”

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