The pain of baby heartburn: Does your child show the sometimes subtle signs of GER?

Gastroesophageal reflux (GER) is basically baby heartburn. It can lead to problems with breathing and damage to the esophagus. It can happen due to the sphincter at the top of the stomach being too relaxed and is triggered by certain foods and eating too much at one meal among other things.

There are many signs of GER in infants, but a certain sect of babies show few to no symptoms.

This so-called “Silent GER” shows up as sleeplessness, constant desire to breastfeed, behavioural problems due to pain, and picky eating from a child who has learned that food hurts. GER and Silent GER can erode families if left undiagnosed.

Here’s Dr. Sear’s list of symptoms copied verbatim from his FAQ page on GER. Silent GER can have some or none of the problems listed below. If you suspect something is up with your baby try small frequent meals, sitting upright and still for 30 mins after eating, no food or drink for two hours before bed and naps avoiding classic heartburn foods, keep a diary of food, meal times and behaviour and see your health care practitioner.

Clues that your baby suffers from GER enough to need treatment are:

  • Frequent spitting up or vomiting (not all babies with GER spit up)
  • Baby isn’t outgrowing the “colic” and/or spitting up
  • Frequent blasts of crying that are painful cries, not just baby cries
  • Your gut feeling tells you that your baby “hurts somewhere”
  • Bursts of nightwaking “as if in pain”
  • Colicky, abdominal pain after eating, even as long as one hour afterwards
  • Poor sleep habits, restless
  • Writhing as if in pain: drawing up legs, arching back
  • Erratic feeding patterns. Refuses to feed or wants to breast or bottlefeed all the time.
  • Frequent “wet burps” or “wet hiccups”
  • Throaty noises: swallowing noises, choking, gagging
  • Frequent, unexplained colds, wheezing, and chest infections
  • Stop-breathing episodes
  • Excessive drooling
  • Spits up like a “volcano”

Other symptoms in toddlers and older children:

  • Bodily contortions: head tilt or arching back and body twisting motions after eating
  • Swallowing difficulties
  • Bad breath
  • Dental cavities from eroding enamel
  • Eats and/or drinks constantly
  • Doesn’t want to eat
  • Poor weight gain
  • Hoarse voice
  • Excessive drooling
  • Frequent sore throats
  • Respiratory problems: wheezing, frequent coughing, asthma
  • Frequent ear infections
  • Bitter aftertaste in mouth after eating, “sour burps”
  • Post-feeding fussiness


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