Common Symptoms of GERD in Infants (Chronic Reflux)

Frequent Splitting up and Coughing Can Be Signs of Infant GERD

Bottle-feeding a crying baby.
Bottle-feeding a crying baby. SelectStock/Getty Images

Reflux occurs often in normal infants. More than half of all babies experience reflux in the first 3 months of life. Reflux can become a more serious concern in some infants, when medical attention is needed, and knowing the symptoms of chronic reflux is important.

Common infant GERD symptoms include the following:

Frequent spitting up or vomiting

Over half of all infants will spit up at some point during their first three months of life.

Referred to as "happy spitters," they usually don't require treatment, and will usually outgrow this. For some infants, however, this spitting up, or reflux, is severe and requires treatment.

Irritability when feeding

This irritability includes whining, crying, screaming, and fussiness, which can last for varied amounts of time. This irritability can stem from the burning sensation and pain in the esophagus when formula and stomach acid is refluxed into the esophagus.

Refusing food or eating only small amounts

Infants may refuse to eat if pain occurs when they swallow. This pain can be caused by the irritation in the esophagus when formula and stomach contents are refluxed back up into the esophagus.

Arching the back while feeding

When babies are experiencing abdominal pain or discomfort, they will often arch their backs or draw up their legs.

"Wet" burps

When a baby has a "wet" burp, a small amount of liquid is regurgitated as he burps.

Frequent hiccups

Hiccups can be triggered by the stimulation of nerves found in the upper part of the stomach or lower part of the esophagus. The vagus nerve, which runs from the brain to the abdomen, can become irritated. This irritation can come from stomach contents entering the esophagus.

Frequent coughing

A frequent cough may occur if refluxed stomach acid is aspirated, irritating the airways, or when the stomach acid irritates the throat.

Poor sleep habits with frequent waking

When an infant is sleeping and his or her head isn't elevated, this allows stomach contents to press against the lower esophageal sphincter (LES), and can cause it to open inappropriately. When stomach contents are refluxed into the esophagus, it can cause coughing and a choking sensation, which in turn can make sleeping more difficult.

A small number of infants will experience the following less common symptoms including the following:

Difficulty swallowing

Pain caused by refluxed stomach acid into the esophagus can make it difficult for infants to swallow. An obstruction in the esophagus can also make it difficult to swallow, so any signs of swallowing difficulty needs to evaluated by a physician.

Frequent sore throat

When stomach contents back up into the throat, it can cause irritation and a sore throat.

Respiratory problems (such as asthma, pneumonia, bronchitis, wheezing)

Several studies suggest a significant link between GERD and asthma. GERD can affect asthma when refluxed acid from the stomach is aspirated into the lungs, and can make breathing difficult and cause the infant to wheeze and cough. This refluxed acid can cause other types of irritation in the lungs, leading to increased odds of pneumonia and bronchitis.

Excessive drooling

Excessive drooling usually occurs from improper, inefficient, or infrequent swallowing. If irritation is present in an infant's throat because of refluxed stomach acid, the infant may find it difficult to swallow frequently maybe, and thus will drool more.

Hoarse voice

Irritation caused by refluxed stomach acid into the throat can lead to hoarseness.


"Gastroesophageal Reflux in Infants." NIH Publication No. 06–5419 August 2006. National Digestive Diseases Information Clearinghouse (NDDIC). 27 Feb 2008.

Marsha Kay, M.D., Vasundhara Tolia, M.D.. "COMMON GASTROINTESTINAL PROBLEMS IN PEDIATRIC PATIENTS." The American College of Gastroenterology. 27 Feb 2008.

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