• Typical infant reflux, also known as spit-up or GER, is very common for babies in their first year; symptoms lessen as Baby’s muscles get stronger.

• GER is different from GERD, which is a condition with more severe infant reflux symptoms, including uncomfortable, vomit-like spit-up.

• GERD requires medical attention to manage Baby’s symptoms and prevent interruptions to Baby’s development.

As you may have noticed when feeding Baby, spitting up and burping are an expected part of the process. Spit-up is also called infant reflux or GER (Gastroesophageal Reflux), and it occurs when food moves back up from Baby’s stomach. Baby reflux is very common and may happen multiple times a day. But if Baby’s reflux symptoms become more severe, they could point to a condition called GERD. What’s the difference between GER and a condition called GERD, and when should you consult a healthcare provider?

First, it’s important to recognize what typical reflux looks like.

Typical Infant Reflux (GER)

Typical reflux, or GER, occurs when Baby spits up a small amount of breast milk or formula during or shortly after feeding, especially when burping. It will be a milky white or clear color. One key sign Baby is experiencing typical reflux is that when Baby spits up, they tend to still be happy and not in pain. These babies are sometimes called “happy spitters”.

GER symptoms usually last throughout Baby’s first year. As Baby gets older, their improved head and trunk control allows them to stay upright when sitting, which helps reduce reflux. The introduction of solid food may also help.

When to Expect GER Symptoms

• GER begins around 2-3 weeks old, once Baby’s feeding patterns become regular.

• Symptoms peak around 4-5 months, when Baby has a larger appetite and becomes more active.

• GER resolves by 9-12 months, when the muscles in Baby’s esophagus are mature, and Baby spends most time upright.

Ways to Reduce Spit-up

• Burp Baby during feedings (every 2-3 ounces of breast milk/formula or each time you switch breasts) and right after. If spit-up becomes frequent, try increasing burping to every ounce of breast milk/formula, or every 5 minutes during breastfeeding.

• Wait at least 15-30 minutes after feedings to do floor time or lay Baby down to sleep. Keep them upright during this time. (Try these low-movement activities while you wait!)

• If Baby gets reflux during Tummy Time, try positioning them at an incline by placing a rolled blanket or pillow under their chest.

Gastroesophageal Reflux Disease (GERD)

Some babies may experience reflux that is uncomfortable, forceful, and vomit-like. This type of reflux is called Gastroesophageal Reflux Disease, or GERD. GERD has different symptoms from GER, and can interrupt Baby’s development if not addressed.

So what are the signs of GERD? Look to see if Baby:

• Spits up with force

• Arches their back during or after eating

• Gags or has problems swallowing

• Is unusually irritable after eating

• Refuses food

• Isn’t gaining weight

• Has reflux symptoms beyond 12 months

If Baby is showing signs of GERD and having trouble feeding, contact their healthcare provider. GERD is a manageable condition, and healthcare providers will be able to give treatment tips to help reduce GERD symptoms.