Spitting up is a normal part of the first year of life for most infants. The Children's Digestive Health and Nutrition Foundation points out that this spit-up can also be called reflux. A bit of acid reflux in babies is not usually a problem. When the baby seems uncomfortable and has other symptoms in addition to the spit-up, the underlying cause may be something more significant called gastroesophageal reflux disease, or acid-reflux disease.
Vomiting
Distinguishing between normal baby spit-up and GERD spit-up can be difficult. A first-time parent can be alarmed by the seemingly large quantity of spit-up that comes out of a tiny baby. Vomiting and large quantities of spit-up are a sign of GERD in an infant. To get an idea of what a large quantity really is, a parent can take a tablespoon of milk or other liquid and pour it on a flat surface. Amounts that appear this size or smaller are generally normal unless other symptoms are present and the spit-up happens at times other than shortly after a meal.
Coughing
Before and after an infant expels a great deal of acidic spit-up, he may cough. The coughing is a result of the acid and regurgitated stomach contents irritating her throat. The American Academy of Family Physicians indicates that a chronic cough is a characteristic symptom of GERD. Some choking is possible as the fluids come up and the infant attempts to swallow them or expel them from the mouth.
Irritability
Irritability is a characteristic symptom of GERD that helps to distinguish it from normal baby spit-up. Babies who spit up, even large quantities, but seem to be happy are often called "happy spitters." A happy spitter doesn't have GERD. GERD makes a baby irritable because of discomfort in the belly and throat. The acid in the stomach contents and regurgitated fluids can burn the baby's chest, just like heartburn in adults, and can cause stomach upset.
Poor Feeding
An infant may begin to associate eating with discomfort if she has GERD. The baby may refuse food or take food when hungry but cry throughout the feeding. Caregivers can be sure the consumption of food is bothering the baby when the infant acts ravenous and suckles just to pull away and cry. In serious cases of GERD, as indicated by the Children's Digestive Health and Nutrition Foundation, an infant may lose weight or fail to gain weight at a satisfactory rate. This is something a pediatrician may notice during routine exams.
Breathing Problems
When an infant vomits or coughs up the stomach contents she may inhale them into the lungs. This can cause breathing problems such as wheezing. In a few cases an infant may develop aspiration pneumonia, a condition that occurs when foods make their way into the lungs and cause inflammation. Stridor, or a high pitched whistling sound when breathing, is a sign of serious GERD, according to the American Academy of Family Physicians. Any unusual sounds or noise when a baby breathes can be a result of acid reflux.
