Reflux in children 1-3 years

Reflux in children 1-3 years: When spitting up becomes a problem

Most infants outgrow physiological reflux by the end of the first year of life. This is helped by the strengthening of the muscular valve between the esophagus and stomach, as well as the transition to solid foods and a more upright body position. However, in some children the symptoms of reflux persist beyond one year or even appear for the first time. At this age it is less often normal and more often requires the attention of a pediatrician or gastroenterologist.

Why does reflux persist in toddlers?

The causes can be varied:

• Gastroesophageal reflux disease (GERD): In some children the lower esophageal sphincter remains weak, leading to pathological backflow of stomach contents into the esophagus.
• Food triggers: Consumption of certain foods can relax the sphincter or increase acidity. These include citrus fruits, tomatoes, chocolate, fatty and fried foods.
• Food allergy: An allergic reaction can cause inflammation of the esophagus (eosinophilic esophagitis), which mimics or worsens reflux symptoms.
• Constipation: A distended intestine raises intra‑abdominal pressure, which "pushes" stomach contents upward.

Reflux symptoms in a toddler

In a child who can already speak, the symptoms become more obvious. They may complain of chest or abdominal pain. In non‑verbal toddlers, indirect signs should be watched for:

• Poor appetite or refusal to eat.
• Irritability, crying after meals.
• Frequent burping, hiccups, sour breath.
• Poor sleep, frequent night awakenings with crying.
• Chronic cough, wheezing, frequent ear infections (due to reflux entering the airways).