Infant reflux, also known as gastroesophageal reflux (GER), occurs when food or milk from a baby’s stomach flows back up into the esophagus. This is common as their digestive systems are still developing. While often harmless and temporary, infant reflux can sometimes indicate a condition like gastroesophageal reflux disease (GERD), which requires medical attention.
Recognizing Common Signs
Parents might notice several signs. Frequent spitting up or vomiting, particularly during or shortly after feeding, is a common indicator. The volume of spit-up can vary, but persistent occurrences may point to reflux.
Irritability and discomfort are also common symptoms. Babies with reflux may cry excessively, especially during or immediately following feeds, and might arch their backs in pain. Some infants may refuse to feed or show difficulty eating, manifesting as gagging, choking, or only consuming small amounts.
Other signs include poor weight gain or even weight loss. Persistent coughing or wheezing, frequent hiccups, or gulping sounds after burping or feeding. These symptoms often vary in their severity among affected infants.
Differentiating From Normal Spitting Up
Distinguishing between typical infant spitting up and problematic reflux can be challenging. Normal spitting up is usually effortless and does not cause discomfort; babies often appear happy and healthy afterward. It often involves small amounts of milk and can occur with burping. This generally decreases as a baby grows older, often resolving by 12 months.
In contrast, problematic reflux often involves more specific characteristics. It might present as forceful or projectile vomiting, where stomach contents are ejected with significant force. Discomfort, pain, or distress associated with the spitting up, such as crying or arching the back during or after feeds, differentiates it from normal regurgitation. Additional accompanying symptoms like feeding refusal, poor weight gain, or respiratory issues such as persistent coughing or wheezing also suggest a more significant reflux issue.
When to Seek Medical Guidance
Certain “red flag” symptoms warrant immediate medical consultation. If an infant is not gaining weight as expected or is losing weight, seek professional help.
Projectile vomiting, or if the vomit contains green or yellow fluid, blood, or appears like coffee grounds.
Difficulty breathing, choking, gagging, or persistent coughing or wheezing can indicate a more serious problem. Persistent irritability, inconsolable crying, or clear signs of pain during feeding also warrant a doctor’s advice. If a baby refuses to feed or has blood in their stool, these are additional signs for medical evaluation.
What Causes Infant Reflux
Infant reflux primarily results from the immaturity of the lower esophageal sphincter (LES), a ring of muscle at the bottom of the esophagus. This muscle acts as a valve, opening to allow food into the stomach and then closing to prevent stomach contents from flowing back up. In babies, this sphincter is not yet fully developed, allowing gastric contents to reflux into the esophagus.
Other factors contribute to infant reflux, including a baby’s predominantly liquid diet and the significant amount of time they spend lying flat. The small capacity of an infant’s stomach can also play a role, as can overfeeding, which can put pressure on the immature LES. As infants grow and their digestive systems mature, the LES strengthens, and reflux symptoms typically improve or resolve by their first birthday.