GERD in Toddlers: What Every Parent Needs to Watch For

Most babies have experienced gastroesophageal reflux, otherwise known as GER or acid reflux. The main symptom of GER is that a baby will spit up after eating. This reflux normally subsides by the time a child is one year old but if it does not go away, it can be an indicator of gastroesophageal reflux disease, or GERD. There are signs parents should look for if they think their toddler has GERD.


According to the National Digestive Diseases Information Clearinghouse, it is common for infants and toddlers to have acid reflux disease. A toddler who still has difficulty keeping down food after their first birthday or seems to have frequent stomach pain may have a chronic case of acid reflux disease. They may frequently say they have an upset stomach and certain foods may trigger this. Some of the largest offenders which trigger reflux are citrus, spicy food, carbonated beverages, gassy vegetables, dairy, and fried food. A toddler may also experience stomach pain after lying down to sleep since this position allows acid to rise in the esophagus.


Reflux and nausea can sometimes precede vomiting in toddlers. This is pretty serious since it usually involves the loss of very important nutrients and electrolytes. Eating food that trigger reflux or foods which produce too much stomach acid could cause vomiting. Toddlers who have acid reflux disease have a lower esophageal sphincter that opens when it should not or may even remain open. This allows the food to leave the stomach, resulting in vomiting. Vomiting which is frequent in nature, occurring more than a couple times per week should be reported to the child’s health care provider.

Sore Throat

Acid levels frequently rising into the esophagus and throat can cause a toddler to complain of frequent sore throats and it may hurt when they try to swallow. Unfortunately, this pain is sometimes misdiagnosed as an upper respiratory issue. However, a sore throat should not be ignored since it is usually one of the first symptoms that toddlers complain of. Also accompanying a sore throat may be a burning feeling in the chest (heartburn), indigestion, and burping. Toddlers have a difficult time communicating these symptoms, so parents need to monitor these symptoms closely.

Weight Loss

Vomiting as a result of GERD can cause weight loss in toddlers since they are not able to keep food down. It can also occur because of loss of appetite and general ill feeling due to pain associated with GERD. Any weight loss by a toddler needs to be immediately evaluated by their pediatrician.

There are steps which a parent can take if they suspect their toddler may have GERD. The first step is to watch their toddler after he or she eats. They can look for signs such as burping, hiccupping, spitting up food and even vomiting. If the toddler seems uncomfortable after eating, or if the child is reluctant to eat, that may also indicate GERD, although many toddlers go through periods where they will not eat certain foods. These signs can be documented in a notebook so that they are easy to share with the pediatrician.

The second step is to watch for more serious complications which can indicate GERD when combined with other symptoms. These include upper respiratory infections, pneumonia, sleep apnea, and asthma.

The third step is to have a doctor perform tests on the toddler GERD symptoms are frequent. There are a variety of tests which can be performed to see if GERD is the cause of their discomfort. Usually, however, treatment is first advised to see if the symptoms go away. If they persist, then testing may be recommended. These tests are performed in an effort to rule out other conditions similar to GERD including: allergies, problems with food absorption, and esophageal malformations.

A fourth step is to follow the advice of the toddler’s pediatrician. This may include administering medication or lifestyle changes to help control GERD. Lifestyle changes include the avoidance of tight clothing which may restrict the abdomen, keeping the child upright for a half hour after eating, and slightly elevating the head of the toddler’s bed. Parents can also avoid feeding the child foods that are common triggers of reflux.

Reflux Triggers

Certain foods can trigger symptoms of GERD and cause discomfort in a toddler. Nitrates, which are often seen in foods such as lunch meat, bacon, and hot dogs, are one culprit. Nitrates can irritate the lower esophageal sphincter which can cause vomiting or gagging.  Some foods can cause the lower esophageal sphincter to relax too much; letting food and stomach acid to leak back up into the esophagus.  Fatty food, fattening milk, chicken skin, cream, citrus, peppermint, spearmint, and chocolate are all foods which can cause the LES to relax and should be avoided.

Beneficial Foods

Although many foods should be avoided, some types of food can be calming to a toddler’s upset stomach and can reduce reflux. Bananas, whole grain bread and cereal, low-fat soup, brown rice, and low-fat frozen yogurt can all help.

Other Diet Considerations

It may be advised by a pediatrician to feed a toddler with GERD several small meals per day instead of three large ones. Large meals can fill the stomach too high and cause reflux. Smaller meals are less likely to exceed the capacity of the stomach and the LES has an easier time handling the smaller meals.

An Immature Digestive System

The most common cause of GERD in toddlers is a result of an immature digestive system, according to the “Gale Encyclopedia.” This problem usually fixes itself as a child grows and their digestive systems mature. While waiting for this maturity, parents can deal with reflux by avoiding feeding their toddler foods which may weaken the lower esophageal sphincter.