Reflux - infants
Gastroesophageal reflux occurs when stomach contents leak backward from the stomach into the esophagus. This causes "spitting up" in infants.
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.
A ring of muscle fibers prevents food at the top of the stomach from moving up into the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES. If this muscle does not close well, food can leak back into the esophagus. This is called gastroesophageal reflux.
A small amount of gastroesophageal reflux is normal in young infants. However, ongoing reflux with frequent vomiting can irritate the esophagus and make the infant fussy. Severe reflux that causes weight loss or breathing problems is not normal.
Symptoms may include:
The health care provider can often diagnose the problem by asking about the infant's symptoms and doing a physical exam.
Infants who have severe symptoms or are not growing well may need more testing to find the best treatment.
Tests that may be done include:
Often, no feeding changes are needed for infants who spit up but are growing well and seem otherwise content.
Your provider may suggest simple changes to help the symptoms such as:
When the infant begins to eat solid food, feeding thickened foods may help.
Medicines can be used to reduce acid or increase the movement of the intestines.
Most infants outgrow this condition. Rarely, reflux continues into childhood and causes esophageal damage.
Complications may include:
Contact your provider if your baby:
Hibs AM. Gastrointestinal reflux and motility in the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 82.
Khan S, Matta SKR. Gastroesophageal reflux disease. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 349.BACK TO TOP
Review Date: 8/10/2021
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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