Symptoms & Causes of GER & GERD in Infants

What are the symptoms of GERD in infants?

The main symptom of gastroesophageal reflux disease (GERD) in infants is spitting up more than they normally do. Infants with GERD can also have some or all of the following recurring symptoms:

  • arching of the back, often during or right after feeding
  • colic—crying that lasts for more than 3 hours a day with no medical cause
  • coughing
  • gagging or trouble swallowing
  • irritability, particularly after feeding
  • pneumonia—an infection in one or both of the lungs
  • poor feeding or refusal to feed
  • poor growth and malnutrition
  • poor weight gain
  • trouble breathing
  • vomiting
  • weight loss
  • wheezing—a high-pitched whistling sound that happens while breathing

What causes GER & GERD in infants?

Gastroesophageal reflux (GER) happens when an infant’s lower esophageal sphincter is not fully developed, and the muscle lets the stomach contents back up the esophagus. Once the stomach contents move up into the esophagus, the infant will regurgitate, or spit up. Once an infant’s sphincter muscle fully develops, he or she should no longer spit up.

GERD happens when an infant’s lower esophageal sphincter muscle becomes weak or relaxes when it shouldn’t. This weakness or relaxation lets the stomach contents come back up into the esophagus.

When should I seek a doctor's help?

Call a doctor right away if an infant

  • vomits large amounts
  • has regular projectile, or forceful, vomiting, particularly in infants younger than 2 months
  • vomits fluid that is
    • green or yellow
    • looks like coffee grounds
    • contains blood
  • has problems breathing after vomiting or spitting up
  • often refuses feedings, causing weight loss or poor growth
  • cries 3 or more hours a day and is more irritable than usual
  • shows signs of dehydration, such as having dry diapers or extreme fussiness
April 2015

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.