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The 10 Signs Of Acid Reflux In Babies

How To Tell Your Baby Has Acid Reflux

Dr. Edward Lewis Profile Photo

Written by Dr. Edward Lewis on September 15, 2021

Medically reviewed by Camille Freking, MS Pharmacology

Acid reflux is a very common ailment that is characterized by a burning pain in the lower chest area. This burning sensation is commonly referred to as heartburn, and while heartburn is related to reflux, the two terms are not interchangeable.

Acid reflux occurs when the valve that connects the bottom of the esophagus, also known as the food pipe, to the stomach malfunctions and allows stomach contents and acids to travel back up and into the esophagus. Typically, the valve at the bottom of the esophagus remains closed at all times except for when you swallow food. Upon swallowing food, the valve temporarily opens to allow the food to pass through and into your stomach, and then it closes again.

However, in babies with acid reflux, this valve may not remain fully closed, especially if their sphincter muscle is not fully developed.

Most babies can experience reflux often, especially in their first year of life. However, reflux may indicate a more serious problem if it’s persistent and severe.

If you suspect that your baby may be having acid reflux, gaining a better understanding of the symptoms of reflux in infants may make it easier for you to identify the problem. Because babies are not able to fully communicate what they are feeling, it can be difficult to determine the problem on your own.

Anytime that you suspect something may be wrong with your infant but you are not sure what is wrong, you should consult your baby’s pediatrician promptly to have your baby evaluated.

Acid Reflux and Gastroesophageal Reflux Disease in Babies: Know the Signs

The most common symptom of acid reflux in adults is pain or a burning sensation in the chest, but because an infant cannot describe this feeling to you, it is important to be on the lookout for other symptoms that are more easily recognizable.

Often, children who are under the age of 12 years old will have different symptoms than the classic symptoms of reflux in adults, and these symptoms might not include the telltale signs that you are familiar with.

The ten most common symptoms of acid reflux in children include:

  1. Burping
  2. Refusal to eat or eating less than normal
  3. Having stomach pain
  4. Becoming very fussy around mealtimes
  5. Frequent vomiting
  6. Having the hiccups
  7. Gagging
  8. Choking
  9. Frequently coughing
  10. Coughing fits that mostly occur at night

Aside from these main signs, acid reflux may also be a symptom associated with frequent ear infections or colds, bad breath, loss or decay of tooth enamel, or a rattling in the chest.

Acid reflux is very common in children who are still in their first year of life, and many babies outgrow it. However, children with Down Syndrome or certain neuromuscular disorder may be at an increased risk of experiencing acid reflux.

Why is Reflux So Common in Babies?

Compared to adults, babies have a weaker valve connecting the esophagus to the stomach. The lower esophageal sphincter (LES) is a group of muscles that controls this valve and keeps stomach acid where it belongs.

A weakened valve makes it more difficult for the body to keep the stomach contents in the stomach. As a result, the valve opens more easily and allows stomach acid to travel back up.

For some babies, the stomach contents may only travel up part of the way, in which case the contents will then travel back downwards, causing heartburn or minor breathing problems. If your child’s stomach acid travels all the way back through the esophagus, it can cause vomiting. However, some children will not show any signs or symptoms at all.

When To See a Doctor For Your Child’s Symptoms

While reflux can be a normal part of early life for many babies, it is also important for you to know the signs of more serious symptoms that should be looked at by a doctor.

You should call your pediatrician if your baby is showing any of the following symptoms:

  • Failure to gain weight
  • Consistent and forceful spitting up that causes stomach contents to shoot of the mouth
  • Spitting up green or yellow fluid
  • Spitting up blood or material that looks like coffee grounds
  • Refusing food
  • Bloody stool
  • Difficulty breathing
  • Chronic coughing
  • Spitting up that begins at age 6 months or older
  • Unusual irritability after eating

These can be indications of a more serious health condition, such as digestive tract blockages or gastroesophageal reflux disease (GERD). Getting a doctor’s opinion as soon as possible when these concerning symptoms appear can help you find a solution more quickly.

Treating Acid Reflux in Babies

If you have consulted a pediatrician and determined that your baby is having issues with reflux, there are a few different approaches that may help you manage your child’s symptoms.

For infants, treatment methods include:

  • Burping your baby when they come to natural pauses during feedings
  • Making sure to keep your infant in an upright position for the 30 minutes following a feeding, and carefully supervising them during this period
  • Offering smaller and more frequent feedings as long as your baby continues to eat enough to keep up with typical growth and development
  • If recommended by your pediatrician, thickening your baby’s formula using a small amount of baby cereal may help reduce the frequency of spitting up. You should never try to thicken the formula without a doctor’s approval.

For an older child, it can be helpful to avoid fried or fatty foods and foods that are very acidic. Fried and fatty foods can slow down the digestive process and may promote reflux.

If your pediatrician approves it, you may be able to safely offer your child an over-the-counter antacid medicine that works to neutralize stomach acids in order to decrease symptoms of acid reflux and GERD.

It is always best to consult your doctor before giving small children or babies any over-the-counter medicine, especially if your child’s symptoms are new and you have not consulted a doctor about them yet.

Your doctor will be able to provide you with any important information about the medicine in question, and they can also answer any questions you might have about your child’s symptoms or how to use the medicine.

Before giving medicine to your child, you should carefully read the drug facts label on the product packaging. This label includes plenty of information about the medicine, including a list of the active and inactive ingredients, the intended purpose and uses of the product, dosing guidelines, general proper use instructions, and information about any potential side effects or circumstances in which patients should not use the product.

If anything is unclear to you about the medicine, your doctor or pharmacist can help clarify. If your baby’s symptoms do not improve with treatment, or if their symptoms seem to worsen in spite of treatment, you should consult your pediatrician promptly for a professional opinion. Worsening symptoms could be a sign of a more serious condition, and your pediatrician will be able to figure out what is causing your little one’s discomfort.

If necessary, your pediatrician may refer you to a pediatric gastroenterologist, and this specialist will be able to offer your further assistance regarding your baby’s concerning symptoms. Anytime your baby is showing symptoms that are worrying you, even if the symptoms themselves seem mild, it is important to consult your pediatrician to play it safe.

The Bottom Line

Acid reflux occurs when the valve that connects the esophagus to the stomach malfunctions and does not stay closed at the appropriate times. In healthy people, this valve stays closed tightly at all times except for when food has been swallowed and needs to travel down into the stomach for digestion. The valve opens briefly to allow for the food to pass through before closing again.

In people with reflux, the valve does not stay closed and allows for stomach contents and acids to travel back up into the esophagus, causing a burning sensation in the chest. For many babies, reflux is a normal part of the first year of life, and it happens because a baby’s valve is weaker than that of the average adult and thus has a harder time functioning.

Many babies will naturally grow out of the reflux stage. However, some babies may end up being diagnosed with chronic acid reflux, or gastroesophageal reflux disease.

If your baby’s symptoms do not resolve regardless of treatment and medical advice, your baby may have gastroesophageal reflux disease.



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