Gastroesophageal reflux (GER) is a condition wherein stomach contents back up, or reflux, into the esophagus, the tube that transports food from the mouth to the stomach. This happens because the muscle at the bottom of the esophagus relaxes when it should remain shut. GER can get worse at 6 months when babies begin trying to sit up, but they typically grow out of it by the time they learn to walk and their muscles get stronger.

“Reflux is not a disease in infants; it’s just a fact,” says Robin Landgraf, R.N., a certified pediatric nurse practitioner at Children’s Medical Center of Dallas who specializes in reflux. “If your baby is a happy spitter and is growing well, don’t worry about it.”

However, in some cases, gastric fluids may damage the throat tissues or spill over into the windpipe, possibly causing asthma and pneumonia.

“Some babies don’t spit up but do have esophageal irritation, and some babies spit up all the time and it doesn’t bother them,” Landgraf says. Some of the most common symptoms signaling irritation, which could be a cause of GER, include heartburn; belching; refusal to eat; stomachache; frequent vomiting; hiccups; frequent cough or coughing fits at night; wheezing; frequent colds; and frequent sore throats in the mornings.

Because the symptoms of GER resemble other medical conditions, consult your child’s pediatrician for a diagnosis. However, only a small percentage of babies have problems that require medication or surgery.

• Thicken your baby’s formula by mixing 1 to 3 teaspoons of plain rice cereal with each ounce of formula or pumped breast milk; a bigger nipple may be required to aid feeding. At least one product, Enfamil AR (which stands for “added rice”), already contains the cereal and thickens when it reaches the stomach.
• If bottle-feeding, keep the nipple filled with milk so the baby doesn’t swallow too much air.
• Burp your baby several times during feeding.
• After feedings, place your baby on his stomach with the upper body elevated at least 30 degrees, or hold him in a sitting position on your lap for 30 minutes.

• Is not growing.
• Has respiratory problems or pneumonia.
• Coughs, chokes or turns blue when feeding.
• Is extremely fussy during and after feeding.
• Arches the back when feeding; “This could be a sign of esophageal irritation,” Landgraf says.