How To Recognize The Signs Of Infant Acid Reflux

Does My Baby Have Reflux?

Is your baby irritable, gagging, or arching during and after feedings? Many parents are not familiar with the symptoms of infant acid reflux and babies often go undiagnosed.

Being a first-time mom of a baby with moderate infant acid reflux, I know the signs all too well.

What Is The Cause of Infant Reflux?

Acid reflux occurs when the ring of muscle between the stomach and esophagus, the lower esophageal sphincter (LES), does not close completely.

In infants, the LES can be weak or underdeveloped causing the stomach fluids and acid to flow back up into the esophagus causing discomfort.

Infant acid reflux peaks at 4 to 6 months and usually goes away by 12 to 18 months of age.

My Journey with Infant Reflux

I realized something was wrong on day two at home from the hospital.

I noticed during feedings that my baby would choke and arch her back in discomfort. I knew right off this is not normal behavior.

She was very difficult to settle and could not be laid flat on her back without gagging or coughing.

I was functioning on little to no sleep and my daughter was crying constantly. My daughter had every symptom except failure to gain weight.

Each feeding was a battle with spit up, back arching, and refusing to take the bottle.

I was at my breaking point. I called my doctor and made an appointment.

The doctor confirmed that my daughter did have reflux along with gas and we started a treatment plan. However, this treatment plan was not a quick fix by any means.

It took several weeks of trial and error to figure out a system that worked best for us.

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Does your baby have reflux? Recognize the signs and symptoms of infant acid reflux including pain, irritability, arching, and discomfort in your baby and learn what strategies work best to alleviate the symptoms.

Signs and Symptoms

  • Spitting up or vomiting
  • Nasal congestion
  • Refusal or difficulty eating/swallowing
  • Frequent hiccups
  • Irritable during and after feeding
  • Arching back during and after feeding
  • Frequent coughing
  • Gagging or choking during and after feeding
  • Failure to gain weight 
  • Disrupted sleep or difficult to settle

What Is The Difference Between Colic and Infant Reflux?

Acid reflux is often overlooked or misdiagnosed as colic.

Since reflux babies are in pain and tend to cry or want to be held more, I can see how people believe their baby is colicky. However, reflux babies cry at all times of the day and can be soothed with certain treatments.

Colic occurs at the same time every day and baby cannot be soothed.

If acid reflux is mild, your baby may be soothed when distracted or held upright for a period of time.

Treatments for Infant Acid Reflux

Disclaimer: I am not a physician and am not giving medical advice. Please consult your physician to approve any recommendations that you read here.

Small, Frequent Feedings and Burp After Each Ounce

The idea behind this treatment is simple. Smaller feedings help your baby to not overeat, which results in less backflow of stomach fluid and acid into the esophagus.

Burping your child frequently during feedings helps to remove gas pockets that could be difficult to pass later and cause discomfort.

Thicken Formula or Breastmilk with Cereal

Our doctor recommended adding one teaspoon of rice cereal for every two ounces of formula.

The thicken formula will be heavier on the stomach and harder for the stomach contents to come back up.

When thickening formula, be sure to go up a nipple size at a time to properly adjust flow. Too small of a nipple will cause your baby to suck vigorously and too large of a nipple can cause choking or gagging.

Hold Upright After Each Feeding

To reduce spit-up and vomiting, our doctor recommended holding our daughter upright after each feeding for 30 minutes.

This helps keep all stomach contents from flowing back in the esophagus before it can be digested.

Inclined Sleeping

I was skeptical about this suggestion at first. Every article I read while pregnant said to only lay your baby flat in an empty crib.

After several weeks of no sleep, I was getting desperate.

Our doctor recommended elevated sleep in a swing or crib wedge. If you have concerns about elevated sleep, speak with your doctor.

There are products available that can monitor your baby’s movement, heart rate, and oxygen levels to help give you peace of mind.

Changing Formula or Introducing Solids

Your doctor may suggest switching to a gentle formula.

I personally noticed the Similac Sensitive Formula to be very foamy and bubbly compared to Gerber Good Start Soothe. The more bubbles your child swallows are more cause for discomfort later.

At this time, your doctor may also check for milk or soy allergies.

Protein allergies in babies can share some of the same symptoms as spit-up, vomiting, and discomfort after eating. However, these symptoms are accompanied by a rash, diarrhea, and blood in the stool to name a few.

If your child is 4 months or older, your doctor may recommend introducing solids a few times a week. Solids will be heavier on their stomach, like the thickened formula, and less likely to regurgitate.

Prescription Medications

For moderate and serve cases of acid reflux, prescription medication may be the only alternative. There are several different types of acid reflux mediation available:

  • Antacids – Mylanta and Maalox
  • Histamine-2 (H2) blockers – Zantac, Pepcid, and Tagamet
  • Proton-pump inhibitors – Nexium, Prevacid and Prilsec

Antacids neutralize stomach acid to help with heartburn and acid indigestion.

H2 blockers help reduce the amount of acid produced by the stomach lining while proton pump inhibitors block the enzyme in the stomach wall that produces acid.

The problem some babies face with prescription medication is that their body becomes immune over time and the medication stops working.


After switching formula, thickening with rice cereal, and holding baby upright after every feeding, my daughter’s acid reflux improved greatly.

Around 4 months old, her reflux returned. At this age, infant acid reflux is at its peak along with teething.

Teething will cause more acid reflux flare ups due to excessive saliva. See my post “How To Survive Teething” for more parenting tips.

Our doctor prescribed Zantac twice a day along with continuing the previous treatment plan. We finally found a happy medium.

After several months on Zantac, we have been able to wean her completely off and only continuing with thickening her formula.

Each treatment plan can be different depending on the severity of your infant’s acid reflux. Speak with your doctor and discuss the best route for your family.

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Author Bio

Erin is the owner and blogger of She is a full-time, working mom that enjoys spending time with her family and creating DIY crafts in her spare time. For a daily dose of humor, be sure to follow her at Instagram – mamabearandcub_blog, Facebook – Mama Bear and Cub, and Pinterest – Mama Bear and Cub.


Reflux Infant Support Association. (2012). Common characteristics of reflux.

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