Infant regurgitation and reflux

Infant regurgitation, gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) all have slightly different symptoms – find out how to differentiate between them

Infant regurgitation and reflux have been defined for FGID management by NASPGHAN*/ESPGHAN** and other worldwide key experts. Both reflux and regurgitation are physiological circumstances frequently appearing (and disappearing) in early life.

Defining GERD

It is essential to differentiate between infant regurgitation, reflux and GERD for infants to receive the best possible care. Common symptoms associated with GERD include esophagitis, obstructive apnea, reactive airway disease, pulmonary aspiration, feeding and swallowing difficulties and failure to thrive.

If GER leads to ongoing, troublesome symptoms that affect everyday functions and are accompanied with other complications³, it could be that an infant has GERD.

Rome IV diagnostic criteria for infant regurgitation

In order to make an accurate diagnosis, symptoms must include both of the following in otherwise healthy infants aged three weeks to 12 months of age:

1. Regurgitation two or more times per day for three or more weeks
2. No retching, hematemesis, aspiration, apnea, failure to thrive, feeding or swallowing difficulties or abnormal posturing³

*North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
**European Society for Paediatric Gastroenterology, Hepatology and Nutrition

References