Spitting up and vomiting are the hallmark symptoms of this condition. As long as the baby is healthy, content and thriving, the reflux is not a cause for concern, as it is only a matter of time before he/she outgrows it.
While babies may get fussy, irritable, or seem to be uncomfortable, it is very unusual for the stomach contents to be acidic enough to irritate the esophagus or throat, as is the case with acid reflux.
Infant reflux is due to a combination of factors:
- In infants, the ring of muscle where the esophagus attaches to the stomach, called the lower esophageal sphincter (LES), is underdeveloped, so it cannot always prevent the stomach contents from flowing backward. Ultimately, the LES will open only when baby swallows and will remain tightly closed the rest of the time, keeping stomach contents where they belong.
- Babies lie flat most of the time, which facilitates reflux. In addition, their diet is completely liquid, also promoting reflux. At times, air bubbles in the stomach may push liquids backward. In other cases, babies gulp large amounts of milk in a short amount of time, so they spit a significant amount when you burp them.
Although infant reflux most often occurs after a feeding, it can happen anytime your baby coughs, cries or strains.
In a small number of cases, however, reflux can be a sign of a more serious problem, such as gastroesophageal reflux disease (GERD), an allergy or a blockage. In GERD, the reflux contains stomach acid which damages the lining of the esophagus.
The following are signs or symptoms of underlying disease, in which case the pediatrician must be notified:
• Your baby isn't gaining weight
• Your baby spits up forcefully, causing stomach contents to shoot out of his or her mouth (projectile vomiting; sign of pyloric stenosis, where the muscle ring that connects the stomach to the intestines is very narrow due to a birth defect)
• Your baby spits up green or yellow fluid
• Your baby spits up blood or a material that looks like coffee grounds (dark brown)
• Your baby refuses food
• Your baby has blood in his or her stool (signs of milk allergy or infection)
• Your baby has difficulty breathing (which means that reflux is irritating his airways)