In plain words
Gastroesophageal reflux is when milk or stomach contents rise back into the esophagus, the tube from the throat to the stomach. In a baby, it often looks like spit-up after feeds. Many babies have it in the first months, and most grow out of it. A baby with reflux can still gain weight and feed well. Reflux becomes a concern when a baby has poor weight gain, pain with feeds, breathing problems, or vomiting that is forceful or green. Those signs need a clinician's look. Reflux can also look like a , which may cause similar symptoms. Parents often notice it most after meals or when a baby is laid flat.
The deeper version
Gastroesophageal reflux is the passage of gastric contents into the esophagus. In infants it occurs many times a day as a result of transient lower esophageal sphincter relaxation and an immature sphincter. Physiologic reflux is distinguished from , the condition with troublesome symptoms or complications. The NASPGHAN and ESPGHAN guideline (Rosen and colleagues, 2018) does not recommend routine acid-suppressive drugs for uncomplicated infant reflux and describes conservative measures first. The differential includes IgE-mediated cow's milk allergy, , , lactose intolerance, constipation, and overfeeding. Red flags include bilious vomiting, blood in stool, poor weight gain, and .
Where it comes up
- Reflux, spit-up, and feedingFeeding Your Baby
- Formula feeding: choosing, preparing, and doing it wellFeeding Your Baby
- Crying, colic, and the witching hourBaby Basics
- Soothing a newbornBaby Basics
- Fussy weeks and developmental changesBaby Basics
What mothers here say about gastroesophageal reflux
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Sources
- Rudolph CD and colleagues (NASPGHAN and ESPGHAN) — Evaluation and treatment of gastroesophageal reflux in infants and children: guideline. Journal of Pediatric Gastroenterology and Nutrition, 2018
- Koletzko S and colleagues (ESPGHAN) — Diagnostic approach and management of cow's-milk protein allergy in infants and children. Journal of Pediatric Gastroenterology and Nutrition, 2012