Reflux: Serious or Not?

Spitting up or having gastroesophageal reflux is common in younger infants, affecting about half of all babies. It occurs when formula, breastmilk, or other food comes back up and out of your baby's stomach, so that your baby spits up or vomits. Simple reflux usually doesn't cause problems though, except for being a little messy.

Spitting up is more of a problem when it is associated with gastroesophageal reflux disease (GERD). Although most infants with reflux don't actually have GERD, those who do can have poor weight gain in addition to spitting up, or they may aspirate and cough, choke, or have difficulty breathing. Crying, refusing to eat, and being irritable for all or most of the day are other symptoms of GERD.

Since reflux is so common, knowing if a child's crying and spitting up are related can be difficult. Reflux may not be causing your baby's crying if he is eager to eat and doesn't cry during, or just after, his feedings. If you and your doctor aren't sure one way or another, you may decide to try an intervention, such as thickening his feedings, using a Tucker wedge and sling, or trying an acid-reducing medication, such as Zantac, Axid, or Prevacid.

Babies spit up so easily because the muscle that usually prevents stomach contents from refluxing backward is immature and not working properly. It is estimated that almost half of babies spit up twice a day. Most don't have any symptoms of a more serious problem, though, and are called “happy spitters.”

Many infants also are tested for reflux. However, the use of additional testing, such as an upper GI test, is not usually helpful in this situation. If your baby is spitting up, then you already know that he has reflux, which will likely show up on the upper GI. And a positive upper GI doesn't mean that your baby is refluxing acid, which is what would be making the reflux painful. However, undergoing an upper GI can be helpful for those babies who are fussy a lot but who aren't spitting up, because the test might detect “silent” reflux, or may indicate if your baby has another medical reason for spitting up or vomiting.

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