Symptoms & Causes of GER & GERD in Children

What are the symptoms of GER and GERD in children?

Symptoms of gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) vary by age among children. Symptoms of GER and GERD in older children and teens may be similar to symptoms in adults. Symptoms in young children may be more similar to those seen in infants.

GER and GERD commonly cause symptoms such as

  • heartburn, a painful, burning feeling in the middle of the chest, behind the breastbone, rising from the lower tip of the breastbone toward the throat. Heartburn is more common in older children and teens than in young children.
  • regurgitation, or stomach contents coming back up through the esophagus and into the throat or mouth, which may cause a child to taste food or stomach acid. Vomiting may occur along with regurgitation.

However, not all children with GER or GERD have heartburn or regurgitation. Other symptoms may include

A child coughing.Symptoms of GERD may include cough.

In children who are too young to describe their symptoms well, parents may notice signs of GER or GERD such as

  • arching of the back and abnormal movements of the neck and chin
  • irritability or crying more than usual
  • loss of appetite or refusing to eat
  • poor growth, weight loss, or gaining less weight than expected

Call a doctor right away if your child has signs or symptoms that could be related to a serious health problem other than GERD or a GERD complication. Examples include

  • problems breathing
  • problems swallowing or pain while swallowing
  • refusing food repeatedly, causing weight loss or poor growth
  • signs of bleeding in the digestive tract, such as
    • vomit that contains blood or looks like coffee grounds
    • rectal bleeding or stool that contains blood
  • signs of dehydration, such as no tears when he or she cries
  • vomiting
    • in large amounts
    • that is regularly forceful, also called projectile vomiting
    • with bile in the vomit, which makes the vomit green or yellow in color

What causes GER and GERD in children?

The lower esophageal sphincter and diaphragm most often prevent GER, which is when stomach contents come back up into the esophagus. However, having GER once in a while is common.

GERD may develop if the lower esophageal sphincter becomes weak or relaxes when it shouldn’t, which may occur due to

  • being overweight, having obesity, or having a large waist size
  • inhaling secondhand smoke
  • factors that are more common in teens, such as smoking or pregnancy

Children are more likely to have GERD if they have health conditions that affect the upper GI tract, including

  • conditions that affect the nervous system, such as cerebral palsy
  • conditions that affect the lungs, such as cystic fibrosis
  • hiatal hernia, a condition in which the opening in the diaphragm lets the upper part of the stomach move up into the chest
  • previous surgery to correct esophageal atresia, a type of birth defect

Some medicines can cause GERD or make GERD symptoms worse. Talk with your child’s doctor about any medicines he or she takes and whether those medicines could play a role in GERD.

Last Reviewed November 2020
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.