Gastroesophageal Reflux (GER)
What is Gastroesophageal Reflux (GER)?
Some babies experience gastroesophageal reflux (GER). This occurs when the muscle at the entrance to the stomach, known as the lower esophageal sphincter (LES), relaxes at inappropriate times. As a result, stomach contents—including milk or food—can flow back into the esophagus.
What are the possible symptoms?
Signs that may suggest gastroesophageal reflux include:
- Frequent or significant spit-up after feeds, sometimes occurring several hours after breastfeeding or bottle-feeding.
- Forceful vomiting (“projectile vomiting”).
- Excessive irritability and persistent crying that may indicate discomfort.
- Arching of the back, which may be a sign of pain.
- Refusing feeds or pulling away from the breast during breastfeeding.
- Frequent night waking.
- Poor weight gain or slower-than-expected growth.
- Gagging, choking episodes or difficulty swallowing.
- Respiratory symptoms, such as wheezing or a persistent cough.
Is GER common in babies?
Yes. Spitting up is very common in infants, affecting approximately 70–85% of babies during the first two months of life. In the vast majority of cases, it resolves naturally as the baby grows and does not require any specific treatment. By 12 months of age, around 95% of infants no longer experience reflux.
It is also important to remember that some babies may have significant gastroesophageal reflux while showing only a few symptoms. Conversely, not all babies with GER spit up or vomit.
How is GER managed?
In cases of simple reflux, a few appropriate lifestyle measures are usually sufficient to manage the situation.
If you have any concerns about your baby’s feeding, growth or comfort, talk to your healthcare professional.
Reference:
Czinn S.J., Blanchard S. Gastroesophageal reflux disease in neonates and infants : when and how to treat. Paediatr Drugs. 2013 Feb;15(1):19-27. doi: 10.1007/s40272-012-0004-2.
