Gastroesophageal Reflux Disease (GERD) is a more severe form of acid reflux that affects children, including infants and toddlers. GERD occurs when stomach acid frequently flows back into the esophagus, leading to discomfort, pain, and potential complications if left untreated. While reflux is common in infants and often resolves on its own as they grow, GERD is a chronic condition that requires medical attention. At Intown Pediatric & Adolescent Medicine, we provide comprehensive care for children with GERD, helping families throughout Atlanta manage the condition effectively.
What Is GERD in Infants and Toddlers?
GERD occurs when the muscle at the bottom of the esophagus (the lower esophageal sphincter) does not close properly, allowing stomach acid to flow back into the esophagus. This can cause irritation, discomfort, and in some cases, damage to the lining of the esophagus. While occasional reflux is normal for infants, GERD is characterized by more frequent and severe symptoms that can interfere with feeding, growth, and overall well-being.
According to the American Academy of Pediatrics, about 50% of infants experience some degree of reflux during the first three months of life, but only less than 5% of infants will develop GERD that requires treatment . Understanding the signs of GERD can help parents recognize when it’s time to seek medical care for their child.
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Signs of GERD in Infants and Toddlers
GERD can present with various symptoms depending on the child’s age. Infants and toddlers may not always be able to express their discomfort, so parents should look for key signs and symptoms of GERD:
GERD Signs in Infants
Frequent spitting up or vomiting
While spitting up is common in infants, persistent vomiting or spitting up large amounts after feedings may indicate GERD.
Irritability during or after feedings
Infants with GERD may become fussy, cry, or arch their backs during or shortly after feeding due to discomfort from acid reflux.
Refusal to eat or difficulty feeding
Pain or discomfort from reflux may cause infants to refuse to eat, leading to poor weight gain or failure to thrive.
Coughing, gagging, or choking
Refluxed stomach acid can irritate the throat and airway, leading t
Frequent hiccups or burping
Excess gas or burping after feedings may be a sign that your baby is experiencing reflux.
GERD Signs in Toddlers
Heartburn or chest pain
While toddlers may not be able to describe heartburn, they may complain of a burning sensation in the chest or show signs of discomfort after eating.
Chronic cough or wheezing
Acid reflux can irritate the airway, leading to coughing, wheezing, or recurrent respiratory infections.
Difficulty swallowing
Toddlers may have trouble swallowing food or may refuse to eat certain foods due to discomfort in the throat or esophagus.
Regurgitation of food or sour-tasting liquid
Toddlers with GERD may regurgitate food or sour liquid back into the mouth, particularly after meals.
If your child is showing any of these signs or if you are concerned about their feeding or growth, it is important to consult with a pediatrician for evaluation and diagnosis.
Diagnosing GERD in Infants and Toddlers
At Intown Pediatric & Adolescent Medicine, our experienced pediatricians use a variety of diagnostic tools to determine if your child has GERD. Diagnosis often involves:
Medical History and Symptom Review
We take a detailed history of your child’s symptoms, feeding patterns, and overall growth to identify potential signs of GERD.
Physical Examination
A thorough physical exam helps us assess your child’s growth and any signs of discomfort or distress during feeding.
Monitoring Symptoms
In many cases, we may recommend keeping a diary of your child’s symptoms, including when they occur and what triggers them, to better understand the pattern of reflux.
Diagnostic Tests
In some cases, further testing may be needed to confirm the diagnosis. This may include esophageal pH monitoring, which measures the acidity levels in the esophagus, or upper GI endoscopy, which allows the doctor to view the inside of the esophagus and stomach.
Treatment Options for GERD in Children
Treating GERD in infants and toddlers depends on the severity of the condition and the child’s age. The goal of treatment is to reduce symptoms, prevent complications, and improve the child’s overall comfort and well-being. Common treatment approaches include:
Dietary Modifications
For infants, simple feeding adjustments can often help manage GERD symptoms. These may include:
Smaller, more frequent feedings
Feeding your baby smaller amounts more often can help reduce the volume of stomach contents and prevent reflux.
Upright positioning after feeding
Keeping your baby in an upright position for 30 minutes after feeding can help prevent reflux. For toddlers, avoiding certain trigger foods such as spicy, acidic, or fatty foods may help alleviate symptoms.
Medication
If lifestyle changes are not enough to manage GERD, medication may be necessary. Common medications used to treat pediatric GERD include:
- Acid blockers (H2 blockers) such as ranitidine or famotidine, which reduce stomach acid production.
- Proton pump inhibitors (PPIs) such as omeprazole or lansoprazole, which block acid production and help heal the esophagus.
It’s important to note that medications are typically prescribed for children with more severe GERD symptoms or those at risk for complications, such as poor growth or esophageal damage.
Monitoring and Follow-Up
At Intown Pediatric & Adolescent Medicine, we monitor your child’s progress closely to ensure that treatment is effective. Regular follow-up visits allow us to adjust the treatment plan as needed and address any concerns that may arise.
When to Seek Medical Attention
While GERD can often be managed with lifestyle changes and medication, it’s important to know when to seek medical attention. Contact your pediatrician if your child:
- Refuses to eat or shows signs of poor weight gain.
- Has difficulty swallowing or seems to be in pain when eating.
- Experiences frequent vomiting or spitting up with signs of distress.
- Develops respiratory symptoms such as chronic cough, wheezing, or recurrent pneumonia.
Early diagnosis and treatment of GERD can help prevent complications and ensure that your child grows and develops in a healthy way.
Frequently Asked Questions about GERD in Children
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Reflux is common in infants and usually resolves on its own as they grow, whereas GERD is a more severe, chronic form of reflux that can cause discomfort and requires treatment.
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Frequent spit-up, fussiness during feedings, refusal to eat, poor weight gain, and chronic cough or wheezing may indicate GERD rather than typical infant spit-up.
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Toddlers may experience heartburn, regurgitation, coughing, difficulty swallowing, or irritability after eating, especially after consuming trigger foods.
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Diagnosis is based on a review of symptoms, feeding history, and sometimes diagnostic tests like esophageal pH monitoring or upper GI endoscopy to confirm the severity of reflux.
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Treatments include feeding adjustments (smaller, more frequent feedings), upright positioning after meals, and, in some cases, medications such as acid blockers or proton pump inhibitors.
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Yes, untreated GERD can lead to complications like esophagitis (inflammation of the esophagus), poor growth, respiratory issues, and feeding aversions in children.
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Not always. Mild cases may be managed with lifestyle and dietary changes, but more severe cases may require medications to reduce acid production and relieve symptoms.
Schedule an Appointment for GERD Treatment in Atlanta
If your child is showing signs of GERD or if you have concerns about their feeding and growth, contact Intown Pediatric & Adolescent Medicine to schedule an appointment. Our team of pediatric experts provides comprehensive care for infants and toddlers with GERD at our locations in Glenwood Park, Brookhaven, and Decatur, serving families across Atlanta.