Acid reflux is common in infants and often resolves by 12-18 months. Older children and teens may have heartburn, cough, or feeding refusal. Pediatric guidelines recommend conservative measures first (feeding changes, positioning, thickened feeds, allergy evaluation) and cautious, targeted use of acid-suppressing drugs for persistent or complicated cases. Seek prompt care for poor weight gain, severe vomiting, blood in vomit or stools, or breathing problems.

What is acid reflux in children?

Acid reflux (gastroesophageal reflux) happens when stomach contents flow back into the esophagus. In infants this is usually a normal, short-lived process. When reflux causes troublesome symptoms or complications - poor weight gain, esophagitis, respiratory problems - clinicians call it gastroesophageal reflux disease (GERD).

How reflux looks at different ages

Infants

Frequent spitting up or regurgitation is common in the first months of life and often peaks around 3-4 months before improving by 12-18 months. Parents may notice feeding difficulties, persistent crying during or after feeds, or slow weight gain. Most healthy, thriving infants with only spit-up do not need medication.

Toddlers and school-age children

Older children may complain of heartburn, abdominal pain, chronic cough, hoarseness, or recurrent sore throat. They may refuse meals or vomit more easily than peers. These symptoms can overlap with allergies or asthma.

Adolescents

Older children often describe classic heartburn or regurgitation. Persistent or severe symptoms warrant evaluation because untreated reflux can cause inflammation or affect quality of life. Estimates of how many adolescents are affected vary; some studies report low single-digit percentages while others report higher rates .

When to seek medical care

See a pediatrician if your child has poor weight gain, repeated choking or breathing problems, blood in vomit or stool, persistent vomiting, or severe pain. A doctor will assess growth, feeding history, and may recommend tests if alarm signs appear.

Typical evaluation and treatment approach

Current pediatric guidelines emphasize conservative care first. For infants that are otherwise well, steps include smaller, more frequent feeds, upright positioning after feeds, and considering a brief trial of thickened feeds for symptomatic regurgitation. Elimination of cow's-milk protein can be considered when symptoms suggest milk protein allergy.

Medications (H2 blockers, proton pump inhibitors like omeprazole) may be appropriate when symptoms persist despite conservative measures or when there is evidence of esophagitis or complications. Ranitidine was withdrawn from many markets because of contamination concerns. Long-term acid suppression has risks and should be used under pediatric guidance.

Prokinetic and surgical options (e.g., fundoplication) are reserved for rare, severe cases or when there are complications despite medical therapy.

Overlap with other conditions

Reflux symptoms can mimic or coexist with asthma, sinusitis, or allergies. Careful history and targeted testing help differentiate these causes.

Prognosis

Most infants outgrow reflux without long-term effects. Persistent or severe GERD can lead to complications and requires specialist care. In adults, chronic GERD increases the risk of Barrett's esophagus and esophageal adenocarcinoma; these complications are uncommon in children.

  1. Confirm published prevalence ranges for reflux symptoms in adolescents and provide representative sources.

FAQs about Acid Reflux In Children

Is spitting up normal in babies?
Yes. Frequent spitting up is common in early infancy and usually resolves by 12-18 months. See a doctor if the baby is not gaining weight or shows other worrying signs.
When are medicines needed for pediatric reflux?
Medications like proton pump inhibitors may be used when conservative measures fail or if tests show esophagitis or complications. A pediatrician should supervise their use because of potential side effects and limited benefit in uncomplicated infant reflux.
Can reflux cause breathing problems?
Reflux can irritate the airway and is sometimes linked to chronic cough, wheeze, or repeated pneumonia. Doctors will evaluate for multiple causes and treat the most likely contributors.
Should I change my baby's formula or diet?
Some infants improve after smaller, more frequent feeds or a brief trial of thickened feeds. If cow's-milk protein allergy is suspected, a supervised elimination trial may help. Discuss changes with your pediatrician before starting.

News about Acid Reflux In Children

Gastroesophageal Reflux Disease - Children - UF Health - University of Florida Health [Visit Site | Read More]

Managing GERD in Children with Asthma with H2 receptor antagonists (H2RAs): Indian Paediatricians'... - Medical Dialogues [Visit Site | Read More]

Dad thought he had acid reflux - telling kids diagnosis was 'hardest thing' - Wales Online [Visit Site | Read More]

Gastroesophageal Reflux in Infants and Children: Diagnosis and Treatment - American Academy of Family Physicians [Visit Site | Read More]

Evaluation of the relationship between gastroptosis and reflux in pediatric patients - Frontiers [Visit Site | Read More]

Avoid PPIs, H2 Blockers for GER in Infants, Expert Warns - Medscape [Visit Site | Read More]

Association Between Dinner-to-Bed Time and Gastroesophageal Reflux-Related Diseases in Children - Cureus [Visit Site | Read More]