Gastroesophageal reflux occurs when stomach contents leak backward from the stomach into the esophagus. This causes "spitting up" in infants.
When a person eats, food passes from the throat to the stomach through the esophagus. The esophagus is called the food pipe or swallowing tube.
A ring of muscle fibers prevents food at the top of the stomach prevents food from moving up into the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES. If this muscle doesn't close well, food can leak back into the esophagus. This is called gastroesophageal reflux (GERD).
A small amount of gastroesophageal reflux is normal young infants. However, ongoing reflux with frequent vomiting can irritate the esophagus and make the infant fussy. Severe reflux that causes weight loss or breathing problems is not normal.
The health care provider can often diagnose the problem asking about the infant's symptoms and doing a physical exam.
Infants who have severe symptoms or are not growing well may need more testing to find the best treatment.
Tests that may be done include:
Often, no feeding changes are needed for infants who spit up but are growing well and seem otherwise content.
Your doctor or nurse may suggest simple changes to help the symptoms such as:
When the infant begins to eat solid food, feeding thickened foods may help.
Medicines can be used to reduce acid or increase the movement of the intestines.
Most infants outgrow this condition. Rarely, reflux may continue into childhood and can cause esophageal damage.
Call your health care provider if your baby is vomiting often.
Reflux - infants
Orenstein S, Peters J, Khan S. Gastroesophageal reflux disease (GERD). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 315.
Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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