New Study: GERD Infants in Feeding and Therapeutics (GIFT)

First published November 2023
Updated November 2025

Adapting to a new routine after a baby is born poses its own challenges; however, this can be more frustrating or confusing to parents when their baby is also irritable and having difficulty with their feeding. These moments are especially challenging when parents and health care providers can’t figure out why this is happening.

Babies who present with such behaviors are often diagnosed with gastroesophageal reflux disease (GERD) and are started on medications and other treatments. Accurately diagnosing GERD and determining which treatments are truly effective remains unclear.

What is GERD?

GERD is a disease caused by the lower esophageal sphincter (a muscle that regulates food movement between the food pipe and the stomach) either not closing or opening at the wrong time. As a result, food and stomach acid can flow back into the food pipe, sometimes leading to vomiting and discomfort from irritation or pain. Babies with GERD may have difficulty in eating or seem fussy during feeding.

How is GERD Diagnosed?

Research from The Innovative Infant Feeding Disorders Research Program at Nationwide Children’s Hospital Research Institute reveals that GERD is not easy to diagnose based on symptoms alone, and sometimes babies are mistakenly thought to have it. In many cases, behaviors and symptoms that are suggestive of ‘GERD’ may be caused by something else, and treatments like medications or frequent formula changes may not be necessary. At the same time, there are babies with GERD from a true clinical sense who need treatment.

Babies who are fed with breast milk, formula or through a feeding tube can all show GERD-like symptoms, regardless of whether they were born early or full term. The use of pH-Impedance methods has been developed to precisely diagnose GERD. However, figuring out best way to treat remains a challenge, as current research does not yet provide clear answers.

How is GERD Treated?

With grant support from National Institute of Heal (NIH), Dr. Sudarshan Jadcherla and his team are conducting a research study called the GIFT study to explore which treatments are most effective for infants with GERD. The study compares three different approaches:

1. Personalized feeding and nutrition strategies (to strengthen the food pipe muscles and lower esophageal sphincter)
2. acid-suppressive medication (decreases stomach acid)
3. added rice starch formula (thickens in the stomach and minimizes regurgitation)

The goal is to determine which method works best and for how long treatment should continue. This study will help both with clinical diagnosis and with developing best practices for GERD treatment in infants. A win-win situation for babies, parents, providers and community. This knowledge can identify best diagnostic and treatment options and encourage clinicians to also consider other factors that mimic GERD before treating.

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