GERD in Infants | Causes | Symptoms | Complications | Diagnosis | Treatment
Gastro Health Data Verified

GERD in Infants - Causes, Symptoms, Complications, Diagnosis and Treatment

Published on May 25, 2022 and last reviewed on Jan 10, 2023   -  4 min read


Gastroesophageal reflux disease or GERD is commonly experienced in breastfeeding babies. Read the article below to know more about GERD.

What Is GERD?

The esophagus is a tube that carries food from the mouth to the stomach for digestion. GERD (gastroesophageal reflux disease) is a digestive tract disorder that causes reflux of food through the esophagus. It is also commonly known as acid reflux, acid indigestion, or heartburn. Usually, it does not cause any severe symptoms in the infants and resolves on its own when the infants grow up.

What Is GERD in Infants?

Gastroesophageal reflux (GER) is characterized by the passage of stomach contents into the esophagus, which may or may not be associated with regurgitation. It might sometimes be accompanied by spitting up and vomiting.

GERD, a reflux disease, causes repeated GER symptoms that are worrisome and may lead to medical complications. The diagnosis of gastroesophageal reflux (GER) and GERD is based on history and physical examination. GER and GERD are commonly seen in infants and it is usually resolved on their own when the baby grows 12 months old. It is a normal physiologic process that occurs throughout the day in infants. The occurrence of this reflux is less common in children and adolescents.

What Causes GERD in Infants?

Studies have shown that numerous factors contribute to GERD in infants. Some of these factors include:

  • The infants spend most of their time sleeping during the first six months.

  • They will not have a fully developed esophagus and lower esophageal sphincter during this period.

  • The babies are more dependent on liquid food at this stage.

These factors might cause the stomach content to come out through the esophagus and reach the mouth. However, when the infant grows and eats more solids and spends more time in upright positions, the symptoms of GERD reduce gradually on its own.

Infants have a definite possibility of developing GERD if they have the following health conditions:

What Are the Symptoms of GERD in Infants?

GERD commonly causes regurgitation (stomach contents coming out through the esophagus either into the throat or mouth) or spitting up in infants.

Apart from this, it can also affect the infant's life by causing:

  • Choking, gagging, or problems with swallowing.

  • Irritability because of regurgitation.

  • The baby might refuse to eat or swallow, leading to loss of appetite.

  • The baby spits up green or yellow fluid.

  • Abnormal movement of the neck and the chin.

  • Poor weight gain.

  • Wet burps and hiccups.

  • Coughing and wheezing.

  • Vomiting.

How to Diagnose GERD in Infants?

The doctors attempt to review your infant's symptoms and medical history. If your doctor suspects GER or GERD, they might suggest some lifestyle modifications to overcome this problem. However, if the symptoms are severe, your doctor might recommend some tests to rule out GERD. The tests for diagnosing GERD include;

1. Upper Gastrointestinal (GI) Endoscopy:

It is a procedure in which a flexible tube with a camera is inserted to check the lining of the upper GI tract, including the esophagus, stomach, and duodenum. Sometimes, a doctor might take a small piece of tissue for biopsies if needed.

2. Esophageal pH Monitoring:

Esophageal pH monitoring is done to detect acid reflux in the esophagus. Your doctor might suggest this test to detect nonacid reflux. The doctor inserts one end of a flexible catheter into the esophagus through the nose of the infant. The catheter is connected with a monitor for diagnosing the GERD condition. This test can help the doctor detect sleeping, eating, and other esophageal reflux problems. It can also provide an idea about the effectiveness of GERD medicines.

3. Upper GI Series:

It is a procedure in which a doctor uses barium to visualize the upper GI tract with X-rays. It is used primarily to detect anatomic problems of the esophagus and upper GI tract to determine the reasons for symptoms worsening.

What Is the Treatment of GERD in Infants?

Mainly, the infants do not require any treatment as the conditions resolve on their own when the infants turn 12 months or older. The doctor might recommend some diet modifications depending on the age and symptoms experienced by the infant. They will ask you to hold your baby upright for 15 minutes to 20 minutes after feeding. You should avoid exposing the infant to passive smoking. However, based on the severity of the condition, your doctor might suggest some medications. Surgery is usually not recommended and is an option only when the infant is unresponsive to all other treatment modalities.

If you suspect GERD signs in your baby, you should avoid doing any lifestyle modifications without consultation with your doctor. Depending on the age and the symptoms of the infants, your doctor will suggest changes in your baby's diet plan such as,

  • Frequent breastfeeding and avoiding overfeeding.

  • Add cereals to the formula or stored breast milk to make it thicker.

  • Remove cow's milk from the diet as many infants are allergic to the protein in cow's milk and may exhibit signs similar to GERD.

  • Additional calorie intake if your baby is showing poor weight gain.

You must follow the diet guidance plan of your doctor as they would suggest a balanced diet that is essential for your baby's growth and development.

What Are the Associated Complications of GERD in Infants?

The infant with GERD might develop some complications, either concerning the esophagus or some outside esophagus if appropriate treatment is not given in time; the commonly known complications are:

  • Esophagitis.

  • Poor weight gain.

  • Complications outside the esophagus include cough, pneumonia, wheezing, or laryngitis.


GERD is commonly reported in breastfeeding infants. Some studies support that its occurrence in infants might be due to spending long hours in a lying position while sleeping and intake of more liquid food. Various research is being conducted to detect the reason for its increased prevalence in infants than adolescents and children. If you notice frequent gagging or spitting up in your infant, it is advisable to seek the help of your physician at the earliest to get it sorted.

Frequently Asked Questions


How to Treat GERD in Infants?

The reflux of stomach contents into the esophagus refers to gastroesophageal reflux disease (GERD). In infants, it mostly resolves with feeding changes such as:
- Burping your baby after every feed.
- Avoid overfeeding your baby.
- Try changing the formula, as your baby may be sensitive to specific ingredients in the formula.
- Hold the infant in an upright position for 30 minutes.
The pediatrician may suggest the following medications for severe GERD:
- H2 blockers.
- Proton pump inhibitors.


What Are the Symptoms of GERD in Babies?

Infants with gastroesophageal reflux disease (GERD) may face the following issues:
- Problems with swallowing.
- Choking and gagging.
- Coughing.
- Wheezing.
- Forceful vomiting.
- Poor weight gain.
- Increased crying for no other reason (medical conditions).


Does Gripe Water Cure Reflux in Babies?

Gripe water contains different ingredients depending on the manufacturer; the standard includes lemon, ginger, peppermint, and sodium bicarbonate. In addition, the Food and Drug Administration (FDA) has not approved it as a drug to cure reflux in babies. Therefore, it is always advised to breastfeed or formula feed babies below six months, and any other supplements at this stage may cause allergic reactions and infections in babies. It is essential to visit a pediatrician for better advice on GERD in infants, do not give medications or supplements on your own.


How Is Burping Done in a Baby with Reflux?

Burping is considered a part of feeding; it aids in letting out the air that gets swallowed during feeding. The different techniques involved in burping are as follows:
- Make the baby sit on your lap, hold the baby’s chin in one hand and support the chest using the heel of the same hand. Pat, the baby’s back using another hand.
- Lay the baby on your lap, with the baby’s belly lying on your lap. Then, gently pat the baby’s back and make sure the baby’s head is slightly higher than the chest.
- Rest the baby against your chest so that baby’s head lies on your shoulder; now gently pat the baby’s back.


What Causes GERD in Babies?

The various factors that lead to reflux of gastric contents into the esophagus (food pipe) include:
- Improperly developed lower esophageal sphincter (LES).
- Sleeping on the back.
- Intake of liquid foods alone.
- Premature birth.
The conditions that cause GERD in infants are:
- Cystic fibrosis.
- Hiatal hernia.
- Cerebral palsy.


Does Omeprazole Help Babies With Silent Reflux?

Omeprazole is a proton pump inhibitor that aids in decreasing gastric acidity. However, it is not recommended for babies below one year. When babies suffer from gastroesophageal reflux disease (GERD), the pediatrician may suggest specific feeding changes like feeding in an upright position, avoiding overfeeding, and burping. Under severe conditions, the doctor may suggest Omeprazole to relieve the baby from symptoms.


Does the Reflux in Babies Worsen at Night?

The reflux of gastric contents to the food pipe may cause symptoms like gagging, choking, and colic crying in babies. It may worsen at night; the baby has difficulty sleeping and suffers from restlessness. To avoid such trouble at night, the following may help:
- First, do not overfeed the babies.
- Do not make the baby sleep immediately after feeding. Third, burp the babies after every feed.


Does Burping Worsen My Baby’s Reflux?

No, burping does not worsen the baby’s reflux symptoms; rather, it aids in relieving such symptoms. It is an essential step followed by feeding babies, as the babies spend most of their time sleeping. During feeding, the infants swallow air that gets trapped within the stomach to cause reflux symptoms. At the same time, burping the babies aids in relieving the babies from such trapped air. Consult the pediatrician to get the best advice on burping techniques.


Does Overfeeding My Baby Cause Reflux?

Yes, overfeeding babies may result in gastroesophageal reflux. In addition, the following symptoms may occur on overfeeding a baby:
- Vomiting.
- Spitting up.
- Gagging.
- Crying and crankiness.
- Burping.
To prevent this,
- Feed your baby every two to four-hour intervals.
- Do not overfeed.
- Burp your babies after one to two ounces of feeding.
- Hold the baby in an upright position for 30 minutes before bedtime.


Does GERD in Babies Lead To Diarrhea?

Gastroesophageal reflux disease may result in changes in bowel symptoms in babies. The high acid content in the stomach may irritate the digestive system and result in loose and frequent stools. It results in excess loss of body fluids. As a result, the poop may appear yellow. Factors like spicy food, overfeeding, and stress may worsen the condition. It is advisable to visit a pediatrician to relieve the babies from bowel changes.


Does GERD Go Away in Infants?

Gastroesophageal reflux disease in infants is a treatable condition. The symptoms are usually high during the 4th month, and it resolves within 12 to 18 months. It is infrequent for the situation to last after 24 months. If it persists, it may cause the following signs:
- Wheezing.
- Cough.
- Poor weight gain.


How to Treat a Child’s Acid Reflux Cough?

Frequent cough is also a common symptom of persisting GERD in infants or toddlers. It is advised to follow the below-listed methods to avoid severe symptoms like cough,
- Avoid fried foods, caffeine, tea, soda, citrus fruits, etc.
- Do not overfeed in one sitting; instead, split the food into smaller portions and offer them at equal intervals.
- Avoid feeding two to three hours before bedtime.
- Avoid certain medications like antidepressants and antihistamines that increase GERD symptoms.

Article Resources

Last reviewed at:
10 Jan 2023  -  4 min read




Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

Fundamental Facts About Flu or Influenza

Article Overview: ‘Flu’ can be a commonly-heard-of term, but its complications are unheard of. Read the article to gain fundamental knowledge about influenza to prevent its occurrence. Read Article

Agatha Nzou Mwia
Agatha Nzou Mwia
General Practitioner

What Is Influenza? Influenza is a common viral infection that can be deadly, especially in high-risk groups. It is a respiratory infection that can spread even before the person knows that they are infected. Many people confuse the flu with the common cold. Both are different in terms of their sever...  Read Article

Popular Articles Most Popular Articles

Do you have a question on Gerd In Infants or ?

Ask a Doctor Online

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.