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Does My Irritable Baby Have GERD?

Nov 22, 2023
newborn in the NICU

One of the most frustrating times for a new parent is when their baby cries, arches their back and is irritable — and the parent can’t figure out why. A lot of times, babies who arch and are irritable are diagnosed with gastroesophageal reflux disease (GERD), based on these behaviors alone. 

But a new study adds to a growing body of evidence that arching and irritability are usually NOT caused by GERD. 

GERD is a disease in which the lower esophageal sphincter does not close or opens at the wrong time. As a result, food and stomach acid can come back up and be vomited, which can cause pain from irritation in a baby’s esophagus. GERD can cause difficulty in eating or refusal to eat, along with crankiness during feeding. One visible behavior that parents often attribute to GERD is arching of the back, potentially in response to the burning sensation in the esophagus.

The new study observed more than 500 infants in the newborn intensive care unit (NICU). Researchers found that less than 10% of the arching and irritability events happened after acid reflux. And when they compared acid biomarkers in two groups of infants (those who arched and were irritable often and those who didn’t), they didn’t find any association. In fact, the researchers learned that 92% of arching and irritability events had other causes. Notably, babies who were born preterm were more likely to express arching or irritability, which could be related to neurologic or lung problems associated with prematurity.

No parent or caregiver wants to hear that they simply have a fussy infant, but it is important and positive to know that not all arching and irritability is because of GERD. This knowledge can help lessen the use of prescription or over-the-counter acid-reducing medications and encourage clinicians to consider other factors that may be contributing the arching and irritability.

While research continues to show that fussiness is probably not GERD, parents know their child best. You should always share your concerns with your baby’s development, temperament or behavior with your pediatrician. Together, you can explore the best solution for your child.

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Featured Expert

Nationwide Children's Hospital Medical Professional
Sudarshan Jadcherla, MD

Sudarshan R. Jadcherla, MD, is a member of the Section of Neonatology at Nationwide Children's Hospital, a Principal Investigator at the Center for Perinatal Research at The Research Institute at Nationwide Children's Hospital, a Professor of Pediatrics at The Ohio State University College of Medicine and the Medical Director of the Neonatal and Infant Feeding Disorders Program.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.