Recognizing Gastroesophageal Reflux Disease as Your Child Grows

By: Barry Steinmetz, M.D., pediatric gastroenterologist, MemorialCare Miller Children’s & Women’s Hospital Long Beach

Gastroesophageal reflux happens when stomach contents come back up into the esophagus causing the symptom of heartburn. Gastroesophageal Reflux Disease (GERD) can be a more serious and long-lasting form of reflux and is one of the most common GI conditions in children that can happen at any age.

GERD in Infants

It’s normal for babies to spit up, particularly after feedings, but the main sign of GERD in infants is spitting up more than “normal.” About two thirds of all infants spit up many times a day in the first few months of their lives. In most cases, infants stop spitting up between the ages of 12 and 16 months.

Other symptoms include:

  • Irritability
  • Vomiting
  • Refusing to eat
  • Problems swallowing or breathing issues after eating.  

The peak incidence of infantile GERD is at 3 to 4-months-of-age. It can happen when a baby is just born, but is far less common. One of the reasons that GERD happens is because an infant’s lower esophageal sphincter is not fully developed.

At 6 to 8 months, infants start eating solid foods, and solids stay down better than liquids. At 9 to 12 months, their stomachs drop down into the more reflux guarded vertical position, and the close valve between the esophagus and the stomach matures, thus giving reason as to why infantile GERD resolves over time.

Children with GERD who are under 2-years-old have a 97 percent chance of it resolving with time and treatment.

Treatment for infantile GERD depends on the infant’s symptoms and age, but may involve feeding changes, medicines, or even surgery. However, surgery isn’t recommended in most cases because the infants will usually grow out of their reflux given time.

Initial medical treatment of infants with GERD is treated similarly to adults. Acid blockers are given to most kids in medically appropriate amounts once, twice or three times a day. Sometimes multiple medications are used. Each child is different, depending on their degree of GERD and more importantly, its impact on the child.

GERD in Kids and Teens

Nearly 10 percent of teens and pre-teens in the U.S. are affected by GERD. However, most kids with acid reflux are able to lead normal, active lives with lifestyle adjustments and other treatments.

Acid reflux happens to everyone on occasion, but if it happens too often, it can cause irritation or damage to the esophagus. Symptoms of GERD in kids can include:

  • Burning sensation in the chest
  • Chest pain
  • Difficulty swallowing
  • Dry cough

Similar to infants, treatment depends on the child’s symptoms and age and may involve diet changes, medicines or surgery.

There are several ways that GERD can be diagnosed in kids, including imaging, endoscopies and pH monitoring.

MemorialCare Miller Children’s & Women’s Hospital Long Beach was the first hospital in the area to use the Bravo® Implantable pH Probe to diagnose GERD. The probe measures the pH (acidity) levels in a child’s esophagus, which helps physicians determine a unique treatment plan based on their symptoms.

If you start to recognize signs of GERD in your child, it’s important to seek help from a pediatric gastroenterologist in order to get a proper diagnosis and treatment.



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