When stomach acid comes up the esophagus, this can cause symptoms of reflux.

Common symptoms in infants are feeding refusal, recurrent vomiting, poor weight gain, sleep disturbance, respiratory problems (like coughing and wheezing), and irritability. Symptoms in older children include heartburn, pain with swallowing, asthma, chronic cough or hoarseness, recurrent pneumonia, and recurrent vomiting.

What is first treatment? Lifestyle modification. If the infant is being breastfed, modifying the maternal diet may help decrease reflux symptoms.   A 2 to 4 week maternal exclusion diet that restricts milk and egg is recommended. If the child is formula-fed, reducing feeding volume while increasing feeding frequency or thickening the formula may help. Keep infants upright after feedings. In older children, losing weight (if overweight), not smoking or using alcohol and avoiding triggers may be beneficial.

Medications that help include antacids, histamine H2 antagonists (like zantac) and proton pump inhibitors (like prilosec). There are risks in starting young children medication or long-term use of any medication for reflux.

There is surgery. The stomach is wrapped around the esophagus. This is a last resort.