Overview

Infant reflux, when a baby spits up, occurs when food moves back up from a baby's stomach. Reflux occurs in healthy infants multiple times a day. As long as your baby is healthy, content and growing well, reflux is not a cause for concern.

Sometimes called gastroesophageal reflux (GER), the condition is rarely serious and becomes less common as a baby gets older. It's unusual for infant reflux to continue after age 18 months.

Rarely, infant reflux can be accompanied by worrisome symptoms, such as failure to thrive or weight loss. These can indicate a medical problem, such as an allergy, a blockage in the digestive system or gastroesophageal reflux disease (GERD).

Symptoms

Infant reflux generally isn't a cause for concern. It's unusual for the stomach contents to have enough acid to irritate the throat or esophagus and to cause signs and symptoms.

When to see a doctor

See your baby's doctor if your baby:

  • Isn't gaining weight
  • Consistently spits up forcefully, causing stomach contents to shoot out of his or her mouth (projectile vomiting)
  • Spits up green or yellow fluid
  • Spits up blood or a material that looks like coffee grounds
  • Refuses food
  • Has blood in his or her stool
  • Has difficulty breathing or a chronic cough
  • Begins spitting up at age 6 months or older
  • Is unusually irritable after eating

Some of these signs can indicate possibly serious but treatable conditions, such as GERD or a blockage in the digestive tract.

Causes

In infants, the ring of muscle between the esophagus and the stomach — the lower esophageal sphincter (LES) — is not yet fully mature. That allows stomach contents to flow back up. Eventually, the LES will open only when your baby swallows and will remain tightly closed at other times, keeping stomach contents where they belong.

The factors that contribute to infant reflux are common in babies and often can't be avoided. These factors include:

  • Lying flat most of the time
  • Consuming an almost completely liquid diet
  • Being born prematurely

Occasionally, infant reflux can be caused by more-serious conditions, such as:

  • GERD. The reflux has enough acid to irritate and damage the lining of the esophagus.
  • Pyloric stenosis. A valve between the stomach and the small intestine is narrowed, preventing stomach contents from emptying into the small intestine.
  • Food intolerance. A protein in cow's milk is the most common trigger.
  • Eosinophilic esophagitis. A certain type of white blood cell (eosinophil) builds up and injures the lining of the esophagus.
  • Sandifer syndrome. This causes abnormal tilting and rotation of the head and movements that resemble seizures. It's a rarely seen consequence of GERD.

Complications

Infant reflux usually resolves without causing problems for your baby.

If your baby has a more-serious condition such as GERD, he or she might grow poorly. Some research indicates that babies who have frequent episodes of spitting up might be more likely to develop GERD during later childhood.