In infants, a small amount of reflux is normal. Persistent reflux with frequent vomiting, and subsequent irritation of the esophagus is indicated by unrelenting crying and discomfort. Reflux associated with weight loss or reflux that causes breathing difficulty is considered abnormal.

• excessive vomiting during the first few weeks of life
• extremely forceful vomiting
• chroniccough
• wheezing
• apnea or breath-holding spells
• slow growth
• excessive crying as if in pain
• weight loss

There may be a history of episodes of aspiration pneumonia.

Tests that may be performed include:

• X-ray of esophagus (esophagogram using a radio-opaque dye)
• pH probe monitoring of esophagus (see esophageal pH monitoring)

Prop the infant upright for 1 to 2 hours after feeding. This can be helped by use of a reflux board. When the infant begins to eat solid food, thickened foods are preferable to thin foods. Sometimes medications are used to help reduce symptoms, including antacids or Reglan (a prescription medication that improves peristalsis).

The majority of all infants outgrow this condition. In unusual cases, reflux may persist into childhood and cause varying degrees of esophageal damage.

• esophageal irritation and inflammation
• esophageal stricture (scarring and narrowing)
• pneumonia caused by aspirating stomach contents into the lungs

Call your health care provider if your baby is vomiting frequently, especially if the vomiting is forceful or if other symptoms of reflux occur.

Avoid slumped seated position after meals.