Infant GERD vs. colic: what parents need to know

Caring for a newborn can be both joyful and overwhelming, especially if your baby cries often, spits up, or seems uncomfortable. Two common concerns for new parents are Gastroesophageal Reflux Disease (GERD) and colic. While both can be stressful, they are different conditions and require different approaches.

Question: What is infant GER (reflux) and GERD?

Answer: Almost all babies have some degree of reflux, which is when stomach contents flow back into the esophagus due to a weak muscle at the top of the stomach. This is usually harmless and improves by 12-15 months as the muscle strengthens. If the baby is growing well and doesn’t seem bothered, it’s often called a “happy spitter.” When reflux causes pain, poor weight gain, or other complications, it’s considered GERD, which may need medical attention.

Question: What are the signs of infant GERD?

● Arching the back or refusing to feed
● Fussiness or irritability after feeding
● Poor weight gain or growth
● Coughing, wheezing, or frequent respiratory symptoms
● Trouble sleeping or frequent waking

Question: What causes infant GERD?

● Immature digestive system (especially the lower esophageal sphincter)
● Overfeeding or feeding too quickly
● Lying flat for long periods after feeding
● Food sensitivities

Question: How can parents manage reflux or GERD?

Answer: There are lots of changes parents can make if they’re worried their baby is suffering from GERD, including:

● Making adjustment to their baby’s feeding
● Offering smaller, more frequent feedings
● Burping often during and after feeding
● Keeping the baby upright 20-30 minutes after meals
● If bottle-feeding, using a slower-flow nipple
● Feeding based on hunger cues, not the clock
● Avoiding tight clothing or diapers pressing on the stomach
● Following safe sleep guidelines – always place baby flat on a firm surface
● Pediatrician may suggest hydrolyzed formula for formula fed babies
● Breastfeeding parents may try eliminating dairy or other possible triggers (with medical guidance)

Question: When are medications used for GERD?

Answer: If lifestyle changes don’t help or if GERD causes poor growth or breathing issues, your pediatrician may prescribe:

● Acid reducers (famotidine, others)
● Proton pump inhibitors (omeprazole, others)
● Herbal remedies, including gripe water as it has ginger which is soothing to the stomach

These are used cautiously due to possible side effects, and only under medical supervision.

Question: When should parents call the doctor for reflux/GERD?

● Frequent or forceful vomiting
● Blood in vomit or stool
● Poor weight gain or feeding struggles
● Signs of dehydration (dry mouth, <6 wet diapersday, unusual sleepiness) ● trouble breathing, chronic cough, or wheezing

Question: What is colic?

Answer: Colic is excessive crying in an otherwise healthy baby, often starting in the first weeks of life and resolving by 3-4 months. It’s commonly defined by the “Rule of 3,” which includes:

● Crying more than 3 hours per day
● On more than 3 days per week
● For at least 3 weeks

Question: What are the symptoms of colic?

● Predictable episodes (often in the evening)
● Baby may clench fists, arch their back, or pull legs toward belly
● Difficult to soothe during crying spells

Question: What causes colic?

Answer: The exact cause is unknown, but possibilities include:

● Immature nervous system
● Digestive discomfort or gas
● Overstimulation
● Parental stress (which can create a cycle)

Question: How can parents cope with colic?

● Comfort baby with swaddling, rocking, or white noise
● Gentle tummy massage or bicycle legs for gas relief
● Offer a pacifier if baby accepts one
● Track feeding and crying patterns to spot triggers
● Take breaks, ask for help, and remind yourself colic is temporary

Question: What are the key differences between GERD and colic?

● Cause
○ Acid Reflux (Gerd)
○ Unknown (Colic)

● Spitting Up
○ Common (GERD)
○ Rare or minimal (Colic)

● Crying Patterns
○ Often after feeding (GERD)
○ Usually later in the day (Colic)

● Feeding
○ May refuse or feed poorly (GERD)
○ Often feeds well (Colic)

● Duration
○ Can persist past infancy (GERD)
○ Usually resolves by 3-4 months (Colic)

Question: When should parents call the pediatrician for colic?

Answer: If your child has any of the symptoms below, it is time to reach out to their doctor:

● Vomiting that is green or yellow
● Poor weight gain or feeding refusal
● Blood in vomit or stool
● Excessive crying that worsens or seems painful
● Signs of dehydration (dry mouth, few wet diapers, sunken soft spot)

Both GERD and colic are common in infants. While reflux may need medical management if severe, colic is usually temporary and resolves with time. If you’re unsure, always reach out to your pediatrician for guidance.

Dr. Peterson has 10+ years’ experience in pediatrics and is passionate about plant/herbal medicine, is experienced with osteopathic treatments for sports-related injuries, and has training in allergy immunotherapy.