Infant GER and GERD: Signs, Symptoms, and Treatment of Reflux

What is GER?

Also known as indigestion or heartburn, GER (Gastroesophageal Reflux) is a condition characterized by acidic stomach contents regurgitating back into the esophagus. It can be quite painful, and difficult for parents to distinguish from other conditions, such as colic. It is more bothersome for some babies than others, but the effect is the same.

What are the Symptoms?

Symptoms vary in all babies, but many parents notice irritability, crying (truly painful, screaming kind), and squirming, especially when eating or lying down. The baby may wheeze, have a runny nose, cough, and have bad breath. When lying flat, the baby may arch their back and spitting up and vomiting are common. Of course, spitting up can be a symptom, but some babies do not, as the acid may only travel halfway up the esophagus and back down, causing pain but no spitting up or vomiting. Some babies will not eat very much due to the pain, causing weight gain problems. Others will overeat, getting relief from the breast milk or formula, causing weight gain problems of a different kind. If you suspect a problem, watch your child closely and see your pediatrician. If left untreated, GER can lead to GERD (Gastroesophageal Reflux Disease) and your child can be susceptible to weight and growth problems, damage to the esophagus, and possible respiratory problems.

What is the treatment?

Treatment varies based on the severity. For some babies, simple changes in feeding and sleeping are enough, such as sleeping on an incline, eating upright, in smaller amounts throughout the day, and frequent burping. When these changes don't work, medications can be effective. Prescription medications such as ranitidine can be helpful in neutralizing stomach acids, preventing pain (not spit-up). Of course, there are other things you can do to make life a little easier on you and baby. Here are a few tips:

Keep baby upright as much as possible. Gravity really helps to keep stomach contents down.

Breastfeed if possible. Studies show breastfed babies have less reflux, and breast milk digests quicker than formula, leaving the stomach sooner.

Burp often. Burping every few ounces or before switching breasts helps to keep food down.

Keep baby relaxed. Crying can make reflux worse.

Under the advice of a doctor, thicken formula with cereal. Heavier foods tend to stay down in the stomach.

If breastfeeding, try eliminating dairy from your diet. In some babies, cow's milk protein can really aggravate reflux symptoms. Try going without dairy products for a week or so to see if it helps.

Will it ever get better?

It depends. Usually, GER starts to resolve itself around 7 months, as baby is upright more and eating solids. GER is usually gone by 1 year. However, in some children, reflux may be a lifelong problem, but treatable in a variety of ways. The best course of action, whether in young or older children, is to first see your pediatrician, who usually can treat your child's symptoms effectively. However, a pediatric gastroenterologist, a doctor who specializes in the treatment of children's digestive disorders, is the most definitive person on treating GER in children.
In conclusion, GER is quite common in infants, but somewhat uncommonly known to parents. Not all constant crying is colic. You know your baby; if you suspect reflux, see a doctor right away. If you know the signs to look for, you can spare your baby unnecessary pain by seeing a doctor and changing lifestyle habits sooner rather than later.