Treatment for GER & GERD in Infants
How do doctors treat GER in infants?
In most cases, gastroesophageal reflux (GER) in infants goes away before it becomes gastroesophageal reflux disease (GERD), so doctors don’t treat GER in infants.
How do doctors treat GERD in infants?
Treatment for GERD depends on an infant’s symptoms and age and may involve feeding changes, medicines, or surgery.
A doctor may first recommend treating an infant’s GERD by changing the way you feed him or her. The doctor may suggest that you
- add up to 1 tablespoon of rice cereal for every 2 ounces of formula in the infant’s bottles. If the mixture is too thick, you can change the nipple size or cut a little “x” in the nipple to make the opening larger. Do not change formulas unless the doctor tells you to.
- add rice cereal to breast milk stored in a bottle for breastfed babies.
- burp infants after they have 1 to 2 ounces of formula, or burp breastfed infants after nursing from each breast.
- avoid overfeeding infants. Follow the amount of formula or breast milk recommended.
- hold infants upright for 30 minutes after feedings.
- try putting infants on a hydrolyzed protein formula for 2 to 4 weeks if the doctor thinks he or she may be sensitive to milk protein. The protein content of this type of formula is already broken down or “predigested.”
Over-the-counter and prescription medicines
A doctor may recommend medicines that treat GERD by decreasing the amount of acid in the infant’s stomach. The doctor will only prescribe a medicine if the infant still has regular GERD symptoms and if
- you have tried making feeding changes
- the infant has problems sleeping or feeding
- the infant does not grow properly
The doctor will often prescribe a medicine on a trial basis and will explain any possible complications. You shouldn’t give an infant any medicines unless told to do so by a doctor.
H2 blockers. H2 blockers decrease acid production. They provide short-term or on-demand relief for infants with GERD symptoms. They can also help heal the esophagus.
A doctor may prescribe an H2 blocker, such as
Proton pump inhibitors (PPIs). PPIs lower the amount of acid the infant’s stomach makes. PPIs are better at treating GERD symptoms than H2 blockers.2 They can heal the esophageal lining in infants. Doctors often prescribe PPIs for long-term GERD treatment.
An infant needs to be given these medicines on an empty stomach so that his or her stomach acid can make them work.
Several types of PPIs are available by a doctor’s prescription, including
- esomeprazole (Nexium)
- lansoprazole (Prevacid)
- omeprazole (Prilosec, Zegerid)
- pantoprazole (Protonix)
- rabeprazole (AcipHex)
A pediatric gastroenterologist will only use surgery to treat GERD in infants in severe cases. Infants must have severe breathing problems or a physical problem that causes GERD symptoms for surgery to be an option.
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 through its clearinghouses and education programs 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.