Gastroesophageal reflux in infants

• Alternative Names

  Reflux - infants

• Causes, incidence, and risk factors

  In infants, a small amount of gastroesophageal reflux is normal. 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.

• Symptoms
  • Chronic cough
  • Excessive crying as if in pain
  • Excessive vomiting during the first few weeks of life
  • Extremely forceful vomiting
  • No breathing or breath-holding spells
  • Slow growth
  • Weight loss
  • Wheezing
• Signs and tests

  The health care provider can often make the diagnosis based on the patient's symptoms and physical examination.

  Tests that may be done include:

  • Esophageal pH monitoring to determine how often and for how long stomach acid enters the esophagus
  • X-ray of the esophagus
  • X-ray of the upper gastrointestinal system after the baby has been given a special liquid, called contrast, to drink
• Treatment

  If your baby has reflux problems, hold the baby upright for 20-30 minutes after feeding. Raise the head of the crib, if possible.

  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.

• Expectations (prognosis)

  The majority of infants outgrow this condition. In unusual cases, reflux may persist into childhood and can cause varying degrees of esophageal damage.

• Complications
  • Aspiration pneumonia caused by stomach contents passing into the lungs
  • Irritation and swelling of the esophagus
  • Scarring and narrowing of the esophagus
• Calling your health care provider

  Call your health care provider if your baby is vomiting frequently, especially if the vomiting is forceful or if other symptoms of reflux occur.

• References

  Orenstein S, Peters J, Khan S, Youssef N, Hussain SZ. Gastroesophageal reflux disease (GERD). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 320.

Review Date: 8/2/2009

Reviewed 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.