Lots of babies spit up after eating, which can be a symptom of gastroesophageal reflux (GER), or acid reflux. It may cause an infant to be fussy, and it can certainly be messy, but it's not usually a problem beyond that. In fact, the majority of babies have reflux during their first three months, but "most stop spitting up between the ages of 12 to 24 months," according to the National Digestive Diseases Informational Clearinghouse, which is a division of the National Institutes of Health (NIH). However, some infants develop complications, which are marked by specific warning signs.
Pain or Discomfort
If your baby spits up every day, she needs to be watched to see if symptoms get worse. The Pediatric/Adolescent Gastroesophageal Reflux Association, or PAGER, calls this "Wait and Watch Reflux." The first sign you may notice is that she seems to be in pain or discomfort after feeding, crying inconsolably or arching her back or neck. Sometimes this is due to abdominal pain or heartburn, but in more serious cases can be caused by esophagitis, which is redness, irritation or bleeding in the esophagus.
Sleep Disturbance
Since lying horizontally allows stomach acid to easily back up into the esophagus, a baby with reflux often has difficulty sleeping, or awakens often during the night. In more severe cases, an infant can have trouble breathing at night or even stop breathing for a few moments, which is called sleep apnea. These symptoms are especially likely to occur if you put your baby down to sleep immediately after he eats, instead of allowing him to remain awake and upright for at least half an hour.
Feeding Issues
Some babies feel so much discomfort from GER that they'll become picky eaters, or even refuse to eat. As a result they may be slow to gain weight, or even lose weight. Infants need to consistently gain weight to remain healthy, and will fail to thrive if they don't. GER is said to have progressed to GERD, or gastroesophageal reflux disease, when this occurs, according to PAGER.
Infections
Another sign that GERD has developed is if your baby gets other seemingly unrelated medical conditions, such as infections in the ear or sinuses, asthma, bronchitis or pneumonia. Early warning signs of these complications include coughing, choking, wheezing, and noisy breathing, which are often caused by regurgitated stomach contents ending up in the lungs, trachea or nose.
