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Reflux in Children
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Digestive System

Reflux in Children

While occasional reflux is common in children, persistent symptoms may indicate gastroesophageal reflux disease (GERD), which requires medical attention.

What is reflux (GER) and GERD?

Gastroesophageal reflux (GER) occurs when food or stomach acid flows back from the stomach into the esophagus. Occasional reflux is common. Gastroesophageal reflux disease (GERD) is a more serious, long-lasting condition that can cause repeated symptoms or damage to the esophageal lining. A provider may diagnose GERD if reflux causes pain, feeding problems, or irritation.

Causes

Reflux occurs when the lower esophageal sphincter—the valve between the esophagus and stomach—relaxes when it shouldn't. Contributing factors include:

  • Hiatal hernia
  • Increased abdominal pressure from being overweight or having obesity
  • Certain medicines (e.g., for asthma, allergies, depression, or pain)
  • Smoking or secondhand smoke exposure
  • Previous surgery on the esophagus or upper abdomen
  • Developmental delays or neurological conditions like cerebral palsy
  • Lung conditions such as cystic fibrosis

Symptoms

Symptoms vary by age but may include:

  • Heartburn (burning in the chest or throat)
  • Bad breath
  • Nausea or vomiting
  • Trouble or pain when swallowing
  • Cough, hoarseness, or breathing problems
  • Wearing away of tooth enamel

Diagnosis

Providers often diagnose reflux based on health history. If symptoms persist, common tests include:

  • Upper GI series: X-rays taken after the child consumes a barium liquid.
  • Esophageal pH and impedance monitoring: A thin tube measures acid levels in the esophagus over 24 hours.
  • Upper gastrointestinal (GI) endoscopy and biopsy: A flexible tube with a camera examines the GI tract and collects tissue samples.

Treatment and Management

Lifestyle changes are the first line of treatment, including maintaining a healthy weight, eating smaller meals, avoiding trigger foods, and staying upright after eating. If these are insufficient, a provider may prescribe medication to reduce stomach acid. In rare cases, surgery may be considered. If left untreated, GERD can lead to inflammation, scarring, or Barrett's esophagus.

Frequently Asked Questions

The first line of defense is often non-medical. For infants, keeping the baby upright for 20 to 30 minutes after feeding can help. For older children, maintaining a healthy weight, eating smaller, more frequent meals, and avoiding trigger foods like citrus, tomatoes, chocolate, and spicy items can reduce symptoms. It is also important to keep the child upright after eating and avoid lying down immediately before sleep.
Simple reflux is common in infants and usually resolves on its own without causing significant distress or health issues. You should suspect GERD if your child has persistent symptoms such as frequent vomiting, refusal to eat, weight loss or poor weight gain, chronic cough, wheezing, or signs of pain during feeding. If these symptoms interfere with daily life or growth, a medical evaluation is necessary.
Yes, certain medications used to treat asthma, allergies, depression, or pain can relax the lower esophageal sphincter, worsening reflux. Additionally, exposure to secondhand smoke is a known trigger that can irritate the esophagus and increase symptoms. If your child is on medication that might contribute to reflux, discuss alternative options or timing adjustments with your healthcare provider.
If lifestyle changes do not resolve the symptoms, a provider may order an upper GI series, which involves X-rays taken after the child drinks a barium liquid to visualize the esophagus and stomach. For more detailed assessment, esophageal pH and impedance monitoring may be used to measure acid levels over 24 hours. In some cases, an upper GI endoscopy with biopsy is performed to examine the esophageal lining for inflammation or damage.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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