Gastroesophageal reflux is a condition in which stomach contents leak backward from the stomach into the esophagus (the tube from the mouth to the stomach) after eating. This article discusses reflux in infants.
See also: Spitting up
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.
Once food is in the stomach, a ring of muscle fibers prevents food from moving backward 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).
In infants, a small amount of gastroesophageal reflux is normal. In fact, more than half a babies will have reflux during their first three months.
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.
The health care provider can often make the diagnosis based on the infant's symptoms and physical examination.
Tests may be ordered if your child is not healthy or growing well, or when symptoms are severe and do not get better with treatment. Tests that may be done include:
If your baby or infant is spitting up more than you expect but is still growing well and seems content, no changes in feeding may be needed.
Talk with your doctor or nurse about some simple changes that may be made when feeding:
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.
Call your health care provider if your baby is vomiting frequently, especially if the vomiting is forceful or if other symptoms of reflux occur. Also call if your baby:
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, Medical Director, A.D.A.M., Inc.
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