February 17, 2019/Children's Health

Spitting Up After Meals Isn’t Always Acid Reflux Disease

Regular regurgitation can be common for infants

Father holding crying baby after feeding

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. This is according to 2018 guidelines reported jointly by the North American and European Societies for Pediatric Gastroenterology, Hepatology and Nutrition.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

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’s then referred to as GERD.

Symptoms of GER

GER is marked by constant spitting up of meals and is sometimes accompanied by:

  • 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

Pediatric gastroenterologist Jacob Kurowski, MD, says the complications indicating that your baby may have GERD, or something more serious, include these symptoms of GER, along with:

  • Poor weight gain.
  • Feeding refusal or difficulty feeding.
  • Coughing after feeds.
  • Pneumonia.
  • Excessive irritability (from acid coming up in the esophagus).
  • Sleep disturbances.
  • Vomit that is green (bilious).

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.

If your baby does not improve, a breastfeeding mother may be recommended to eliminate cow’s milk in their diet. A formula-fed baby may have their formula changed to a broken-down protein (hydrolysate).

Medications are only to be used for treating GERD with no improvement after the previous changes, especially when the baby is vomiting or not gaining weight. Surgery is usually reserved for babies who are at risk for life-threatening complications.

Dr. Kurowski notes that the society’s guidelines are helpful in distinguishing infant reflux from more serious disorders, which may 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. Kurowski. “Babies with GERD would benefit from feeding changes as well as medical drug therapy.”


Learn more about our editorial process.

Related Articles

Person holding cup of hot tea, with honey jar floating in background
February 23, 2024/Ear, Nose & Throat
Why Your Throat Tickles — And How To Stop It

Often, a throat tickle is due to a cold, allergies or GERD — but see a doctor if it won’t go away

Person sleeping in a bed using a wedge pillow.
August 15, 2023/Digestive
Will a Wedge Pillow Help My Acid Reflux?

For some lucky people, these pillows can eliminate the need for medications or surgery

Image of apple cider vinegar in a decanter
February 21, 2023/Digestive
Apple Cider Vinegar for Acid Reflux: Does It Work?

There’s not enough research to know, but it’s OK to try it for most

Woman clutching her chest.
December 6, 2022/Digestive
Have Heartburn? Here’s How To Find Relief for Acid Reflux

Lifestyle changes such as diet and weight loss or medication such as antacids can bring relief

woman with soda burps
June 26, 2022/Digestive
Why Do We Burp?

Burping is a normal bodily function

A steaming cup of coffee in a white mug
October 7, 2021/Digestive
Why Does Coffee Bother My Stomach?

Mix up your regular cup, with these low-acid options

Illustration of man with heartburn
November 26, 2019/Digestive
What’s the Difference Between Heartburn, Acid Reflux and GERD?

The short answer from a gastroenterologist

Illustration of food stuck before emptying from esophagus - achalasia
January 28, 2019/Digestive
Is Your Acid Reflux Really Achalasia?

How to know the difference

Trending Topics

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

woman snacking on raisins and nuts
52 Foods High In Iron

Pump up your iron intake with foods like tuna, tofu and turkey