GERD Symptoms in Babies

There are two types of GERD symptoms in babies, common and less common. Common symptoms include frequent spitting up or vomiting, irritability while feeding, refusal to eat or eating just a tiny amount, writhing while feeding, hiccups, frequent coughing, wet burps, and a very disrupted sleep pattern. The less common symptoms include difficulty swallowing, sore throat, respiratory problems, excessive drooling and a very hoarse cry.

GERD symptoms in babies tend to vary and may include only some of those listed above. Let's look at the difference between the common symptoms in a baby with GERD and a baby without the disease: Frequent spitting up or vomiting: While all babies do some spitting up or vomiting, babies with GERD do it severely and far more frequently than normal babies. Irritability when feeding: More than typical fussing, GERD babies may actually scream due to the pain they are experiencing. Refusal to eat or taking just a little bit at feedings: GERD babies often don't want to eat because of the pain it causes them. A burning sensation from the stomach is carried up and into the esophagus, causing them to be quite uncomfortable. Wet burps: All babies burp. Babies with GERD have more wet burps (burps with accompanying liquid). Hiccups: While all babies get hiccups from time to time, GERD babies get hiccups frequently, usually once or twice per day. Coughing: A baby with GERD may aspirate, or breathe in, the refluxed stomach acid, causing significant coughing. Disrupted sleep: When a GERD baby is sleeping, his head is not elevated. This causes the contents of the stomach to press against the lower esophageal sphincter, causing it to open when it shouldn't. This refluxes the contents of the stomach into the esophagus, giving the baby a feeling of coughing or choking and waking him.

The less common symptoms have noticeable effects too: Difficulty swallowing: Pain caused by the refluxed stomach contents makes it difficult for a baby with GERD to swallow. Sore throat: When the stomach contents back up the acid causes throat irritation, which may become very sore. Respiratory symptoms: Many medical studies have found a strong connection between GERD and asthma. GERD affects asthma when refluxed acid is aspirated into the lungs, causing coughing and wheezing. Excessive drooling: All babies drool to some extent, but GERD babies drool more frequently, and it doesn't coincide with a head cold or teething (common causes of drooling for babies without GERD). Hoarse cry: GERD babies' voices are affected by the acid from the refluxed stomach contents, causing a hoarse cry even when they aren't suffering from a cold or allergy.

GERD in babies is caused when a muscle (called the LES) at the lower end of the esophagus doesn't work properly. This muscle normally closes right away when a person swallows, allowing the food to make its way toward the stomach. When it doesn't work properly, however, it allows partially digested food and acid to flow back up, causing a severe burning sensation in the esophagus.

One step in preventing GERD symptoms in babies is to feed them more frequently, with smaller amounts at each feeding. Another is to elevate their heads with a foam wedge when they sleep. Infants will likely require foam wedges on both sides as well as under their heads so they don't fall off the head wedge. Try not to feed an infant right before bedtime. Instead, administer a feeding and try to get the baby to sit up and play or engage in an activity for a while before putting her to bed for the night.

Medications called proton pump inhibitors, or PPIs, are sometimes used for infants with GERD when modifying their diets and lifestyles doesn't yield satisfactory results. There are two widely used PPIs: omeprazole and lanzoprazole. In extreme cases when these medications fail to alleviate GERD symptoms in babies, surgery may be required.