Child care: Gastroesophageal reflux in children

Gastroesophageal reflux involves backward flow of food and gastric acid from the stomach into the esophagus and oftentimes into the mouth. Almost all infants experience episodes of gastroesophageal reflux characterized by burping, spitting or wet burps. The wet burps usually occur right after eating and considered relatively normal.

What are the possible causes?

Among healthy infants, they experience gastroesophageal reflux for various reasons. The circle-like band of muscle at the connection point of the esophagus and stomach typically prevents the stomach contents from entering the esophagus.

In babies, the muscle might be underdeveloped or relax at inappropriate times, thus allowing the stomach contents to flow backward into the esophagus. If the child is held flat while feeding or lying down after feeding, it promotes gastroesophageal reflux since gravity could not hold the material in the stomach.

Overfeeding and drinking carbonated beverages increases the risk for gastroesophageal reflux by increasing the pressure in the stomach. Caffeine and cigarette smoke relaxes the lower esophageal sphincter, thus allowing reflux to readily occur. Remember that nicotine and caffeine can stimulate the production of acid, thus any reflux that occurs is more acidic.

Gastroesophageal reflux

The evident symptoms of gastroesophageal reflux among infants include vomiting and significant spitting up.

Additionally, anatomical irregularities such as constriction of the esophagus, partial blockage of the stomach or abnormal positioning of the intestines can initially mimic gastroesophageal reflux.

What are the indications?

The evident symptoms of gastroesophageal reflux among infants include vomiting and significant spitting up. The reflux usually worsens in the initial several months of life and peaks at around 6-7 months of age and eventually lessens. Almost all infants with reflux outgrow it at around 18 months of age.

In some cases, gastroesophageal reflux can cause complications and progresses to GERD. These complications include feeding issues and irritability due to stomach discomfort that can result to poor growth and episodes of posturing and twisting that is often confused as a seizure.


The treatment for gastroesophageal reflux is based on the age of the child and the ensuing symptoms.

Among infants who have wet burps, the doctor might not recommend treatment or suggest measures such as making the formula thick during feedings, frequent burping and special positioning. The formula can be thickened by adding 1-3 teaspoons of rice cereal per ounce of formula. The nipple should be cross-cut to allow the formula to flow. Those who suffer from reflux must be fed in an upright or semi-upright position and kept in an upright position for 30 minutes after eating.