Gastroesophageal reflux is when food and acid from the stomach go back up into the esophagus, and sometimes out the mouth or nose. Reflux that causes problems like poor growth or damage to the esophagus is called gastroesophageal reflux disease (GERD). Kids with GERD need treatment. Follow these instructions to care for your child.

• If the health care provider prescribed medicine, follow the instructions carefully and give your child the medicine on schedule.
• Check with your health care provider before giving your child any over-the-counter medicines (medicines you can buy without a prescription), including herbs and alternative medicines.
• Help your child avoid:
  • caffeine (found in energy drinks, soda, and coffee)
  • spicy and fatty foods (such as hot sauce and French fries)
  • acidic foods and drinks (such as tomatoes and orange juice)
  • foods made with peppermint or chocolate
  • foods or drinks that make the reflux worse
  • drinking alcohol and smoking cigarettes
• Encourage your child to eat smaller meals more often instead of three large meals.
• Avoid eating too close to bedtime. Lying down on a full stomach can make reflux worse.
• If your child is overweight, talk to your health care provider about how to help your child get to a healthy weight.
• Don't let anyone smoke near your child. It can make your child's reflux worse. If anyone in your house smokes, visit www.smokefree.gov for advice on quitting or call 800-QUIT-NOW.

Your child:

• does not seem to be growing
• coughs, chokes, wheezes, or has trouble breathing
• vomits more than a few times in a 24-hour period
• has blood in the poop or vomit
• still has problems with reflux after 3 months on medicine

What causes reflux? Reflux happens because a ring of muscle at the bottom of the esophagus (the tube that runs from the mouth to the stomach) does not close all the way. This ring of muscle is called the lower esophageal sphincter (LES). If the LES does not close normally, food and fluid from the stomach can come up the esophagus, into the back of the throat, and sometimes out the mouth or nose.

What are the signs of reflux? Kids with reflux may have no signs. Or they may have pain or burning in the upper chest. They may have the feeling of stomach acid coming up into the back of the throat or have a sour taste in the mouth. Other symptoms of GERD include spitting up or vomiting, stomach pain, and cough.

How is GERD diagnosed? Health care providers diagnose GERD by asking about signs of reflux and checking a child's growth. Usually tests aren't needed to know if a child has GERD.