Reflux (GERD) in Infants

Almost all babies have reflux for a few months. Reflux is essentially the stomach contents coming back up through the esophagus. In young babies, the esophagus is immature and the baby may spit up after almost every feeding. This rarely poses any bigger problem than that of laundry. 

Contrary to popular belief, and a belief that some pediatricians still hold, breastfed babies do indeed have reflux and spit up after feedings. Some statistics on spitting up are: 

- Half of all babies 0-3 months spit up within an hour or two of feedings
- Spitting up seems to peak between 2-4 months
- A lot of babies stop spitting up around 6-7 months
- Most babies do not spit up after one year

The rule of thumb is: if your baby is happy and gaining weight well, just be prepared with a burp cloth!

GERD (or Gastroesophageal Reflux Disease) is present in a small number of babies. Many times this condition goes under- or un- diagnosed or is not seen as a “problem” by pediatricians if the baby is still gaining weight. Many mothers are also unaware of the signs of reflux. If the baby doesn’t spit up often or much, but is fussy at feedings, arches and pulls back from bottle or breast, has spells of inconsolable crying, gags and chokes during feedings,and/or hiccups frequently - - - - -check with the pediatrician. Those are all signs of a condition called “silent reflux”. It is hardly silent, since it is characterized by a fussy baby, but refers to the fact that baby is not spitting up frequently or at all. 

There are of course, signs of severe GERD in babies. Some of these include refusing breast or bottle; spitting up blood; breathing problems; and poor or no weight gain. But for this article, I will discuss the more borderline or difficult to diagnose cases of suspected reflux.