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GERD (Gastroesophageal Reflux Disease) in Children

What is GERD?

GERD, or gastroesophageal reflux disease, is a long-term (chronic) digestive disorder. It happens for 1 last update 2020/01/26 when stomach contents flow back up (reflux) into the food pipe (esophagus).GERD, or gastroesophageal reflux disease, is a long-term (chronic) digestive disorder. It happens when stomach contents flow back up (reflux) into the food pipe (esophagus).

GERD is a more serious and long-lasting form of gastroesophageal reflux (GER).

GER is common in babies under 2 years old. Most babies spit up a few times a day during their first 3 months. GER does not cause any problems in babies. In most cases, babies outgrow this by the time they are 12 to 14 months old.

It is also common for children and teens ages 2 to 19 to have GER from time to time. This doesn’t always mean they have GERD.

When GER becomes GERD

Your baby, child, or teen may have GERD if:

  • Your baby’s symptoms prevent him or her from feeding. These symptoms may include vomiting, gagging, coughing, and trouble breathing.
  • Your baby has GER for more than 12 to 14 months
  • Your child or teen has GER more than 2 times a week, for a few months 

What causes GERD?

GERD is often caused by something that affects the LES, the lower esophageal sphincter. The LES is a muscle at the bottom of the food pipe (esophagus). The LES opens to let food into the stomach. It closes to keep food in the stomach. When the LES relaxes too often or for too long, stomach acid flows back into the esophagus. This causes vomiting or heartburn.

Everyone has reflux from time to time. If you have ever burped and had an acid taste in your mouth, you have had reflux. Sometimes the LES relaxes at the wrong times. Often your child will just have a bad for 1 last update 2020/01/26 taste in his or her mouth. Or your child may have a short, mild feeling of heartburn.Everyone has reflux from time to time. If you have ever burped and had an acid taste in your mouth, you have had reflux. Sometimes the LES relaxes at the wrong times. Often your child will just have a bad taste in his or her mouth. Or your child may have a short, mild feeling of heartburn.

Babies are more likely to have a weak LES. This makes the LES relax when it should stay shut. As food or milk is digesting, the LES opens. It lets the stomach contents go back up to the esophagus. Sometimes the stomach contents go all the way up the esophagus. Then the baby or child vomits. In other cases, the stomach contents only go part of the way up the esophagus. This causes heartburn or breathing problems. In some cases there are no symptoms at all.

Some foods seem to affect the muscle tone of the LES. They let the LES stay open longer than normal. These foods include:

  • Chocolate
  • Peppermint
  • High-fat foods

Other foods cause for 1 last update 2020/01/26 the stomach to make more acid. These foods include:Other foods cause the stomach to make more acid. These foods include:

  • Citrus foods
  • Tomatoes and tomato sauces

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  • Being obese
  • Medicines, including some antihistamines, antidepressants, and pain medicines
  • Being around secondhand smoke

What are the risk factors for GERD?

GERD is very common during a baby’s first year of life. It often goes away on its own. Your child is more at risk for GERD if he or she has:

  • Down syndrome
  • Neuromuscular disorders such as muscular dystrophy and cerebral palsy

What are the symptoms of GERD?

Heartburn, or acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain. It begins behind the breastbone and moves up to the neck and throat. It can last as long as 2 hours. It is often worse after eating. Lying down or bending over after a meal can also lead to heartburn.

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Each child may have different symptoms. Common symptoms of GERD include:

  • Burping or belching
  • Not eating
  • Having stomach pain
  • Being fussy around mealtimes
  • Vomiting often
  • Having hiccups
  • Gagging
  • Choking
  • Coughing often
  • Having coughing fits at night

Other symptoms may include:

  • Wheezing
  • Getting colds often
  • Getting ear infections often
  • Having a rattling in the chest
  • Having a sore throat in the morning
  • Having a sour taste in the mouth
  • Having bad breath
  • Loss or decay of tooth enamel

GERD symptoms may seem like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is GERD diagnosed?

Your child''s mouth make a good seal with the nipple during feeding.

  • Adding rice cereal to feeding may be helpful for some babies.
  • Burp your baby a few times during bottle-feeding or breastfeeding. Your child may reflux more often when burping with a full stomach.
  • For children:

    • Watch your child''s provider to review your child’s medicines. Some may irritate the lining of the stomach or esophagus.
    • Don’t let your child lie down or go to bed right after a meal.
    • Always check with your baby’s provider before raising the head of the crib if he or she has been diagnosed with gastroesophageal reflux. This is for safety reasons and to reduce the risk for SIDS and other sleep-related infant deaths. 

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    Your child’s healthcare provider may also recommend other options.

    Medicines. Your child''s acid pump from working.

    The provider may prescribe another type of medicine that helps the stomach empty faster. If food doesn’t stay in the stomach as long as normal, reflex may be less likely to occur.  

    Calorie supplements. Some babies with reflux can’t gain weight because they vomit often. If this is the case, your child''s healthcare provider?

    Call you child's healthcare provider if your baby or child:

    • Has reflux and is not gaining weight
    • Has signs of asthma or pneumonia. These include coughing, wheezing, or trouble breathing.

    Key points about GERD

    • GERD is a long-term (chronic) digestive disorder.
    • It happens when stomach contents come back up into the food pipe (esophagus).
    • Heartburn or acid indigestion is the most common symptom of GERD.
    • Vomiting can cause problems with weight gain and poor nutrition.
    • In many cases, GERD can be eased by diet and lifestyle changes.
    • Sometimes medicines, tube feedings, or surgery may be needed.

    Next steps

    Tips to help you get the most from a visit to your child’s health care provider:

    • Before your visit, write down questions you want answered.
    • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
    • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
    • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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    Request an Appointment

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