Normal Spit Up or GERD (Gastroesophageal Reflux Disease)?

babypukerMost babies spit up.  If you are “blessed” to have your doctor order an upper GI radiological study, results on most babies show some reflux.  I don’t recommend these studies except for rare instances where the concerns involve serious failure to thrive (not gaining weight), or a chronic cough that might involve a TE fistula (tracheo-esophageal fistula).  Consider this normal.  Babies spit up.  So, it’s a matter of how much, how often, and is this spit up causing any harm to the baby?

As physicians, we are required to put a diagnosis for each doctors visit, so for the visit that concerns normal spitting up, don’t be surprised if we put GERD as the diagnosis. 

The article here makes a good point.  If that label (GERD) is used, parents are more likely to want medication. Medication is rarely needed and I reserve its use for the baby who is not able to gain weight due to excessive spit up and for the baby who is so irritable and it is quite apparent that the stomach acid going up the esophagus is a major cause of that irritability. 
http://pediatrics.aappublications.org/content/early/2013/03/27/peds.2012-3070

 

Dr. Paul

 

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