When Infant Reflux Is More Than “Just a Phase”: Why Babies With GERD Deserve to Be Heard
By Dr. Jennifer Harris, Board-Certified Pediatrician and Founder of Crying, Colic, and Beyond
For generations, parents of babies struggling with reflux have heard familiar reassurances:
“It's normal.”
“All babies spit up.”
“They'll grow out of it.”
As a pediatrician, I understand where these reassurances come from. Infant reflux is incredibly common, and for many babies, it is a normal part of development that resolves naturally with time.
But throughout my career, I've also seen the other side of this story.
I've encountered families who have spent weeks, sometimes months, searching for answers. Parents who have been told that their baby's symptoms are simply colic, that crying is part of infancy, or that their child will eventually outgrow their discomfort.
Many of these parents aren't looking for a quick fix. They're looking for someone to listen, to take their concerns seriously, and to help them understand why their baby seems so uncomfortable.
It's one of the reasons comprehensive infant reflux care is so important to me, and why I founded Crying, Colic, and Beyond.
So why has infant reflux historically been so easy to dismiss? And why do I believe we need a more thoughtful, individualized approach to caring for babies with suspected gastroesophageal reflux disease (GERD)?
How “Normal Baby Reflux” Became the Dominant Narrative
To understand why infant reflux is sometimes overlooked, we first need to acknowledge an important medical reality: reflux really is extremely common in babies.
Gastroesophageal reflux (GER) occurs when stomach contents flow backward into the esophagus. Because an infant's digestive system is still developing, this happens frequently, particularly during the first several months of life.
For many babies, reflux is harmless. They may spit up regularly but remain comfortable, feed well, and grow appropriately. These babies are often described as “happy spitters,” and most do not need medical treatment.
Over time, this understanding has understandably shaped how infant reflux is approached in pediatric medicine. We are trained to recognize that most babies with uncomplicated reflux will improve naturally as they mature.
And for many families, reassurance is exactly what is needed.
But I believe the problem arises when the expectation that reflux is harmless becomes an assumption that it must be harmless for every baby.
The fact that most babies outgrow reflux does not mean that every baby experiencing reflux is comfortable in the meantime.
Why Has Infant GERD Been So Difficult to Recognize?
One of the greatest challenges we face when evaluating infant reflux is that babies cannot tell us what they're experiencing.
An older child or adult experiencing acid reflux might describe burning in their chest, a sour taste in their mouth, or pain after eating.
A baby cannot explain any of those sensations.
Instead, we rely on what parents observe: crying, arching, pulling away from feeds, changes in feeding patterns, disrupted sleep, or difficulty settling.
The challenge is that none of these symptoms is exclusive to reflux. They can also occur with feeding difficulties, allergies, normal developmental changes, and numerous other conditions.
This makes diagnosing GERD in infancy genuinely challenging.
There is no single symptom that definitively identifies GERD, and even diagnostic testing has limitations.
Historically, this uncertainty has contributed to two competing problems: some babies have been treated for reflux when something else was responsible for their symptoms, while others with significant reflux-related difficulties have struggled to receive appropriate recognition and care.
Both situations concern me.
As a physician, I don't believe the answer is to assume that every unsettled baby has GERD. But I also don't believe we should dismiss persistent symptoms simply because they are difficult to interpret.
What these babies need is a careful, individualized assessment that considers the full picture.
The Difference Between Reflux and GERD Matters
One of the most important distinctions I make when discussing reflux with parents is the difference between ordinary infant reflux and gastroesophageal reflux disease.
GER describes the movement of stomach contents back into the esophagus. It is common and often harmless.
GERD occurs when reflux leads to troublesome symptoms or complications.
This distinction matters because GERD can affect much more than the amount of milk a baby spits up.
In some infants, reflux-related discomfort or complications can contribute to significant feeding difficulties, poor weight gain, or inflammation of the esophagus.
Some babies may begin to associate feeding with discomfort. Over time, repeated negative feeding experiences can contribute to feeding refusal or aversion, although reflux is only one of several possible causes.
Importantly, the amount a baby spits up does not necessarily reflect the severity of their symptoms. Some babies with substantial regurgitation are perfectly comfortable, while others with concerning feeding behaviors may spit up very little.
And although good weight gain is reassuring, I don't believe it should be the only consideration when evaluating a baby's overall well-being.
A baby can be growing adequately and still have symptoms that deserve careful attention.
That doesn't automatically mean GERD is the cause. It means we need to understand what is happening rather than relying on a single measure of health.
The Pendulum Between Over-treatment and Under-treatment
Over the years, our medical approach to infant reflux has evolved considerably.
At one point, acid-suppressing medications were prescribed relatively readily for symptoms such as crying, irritability, and frequent spit-up.
As research developed, it became increasingly clear that these medications do not reliably improve nonspecific crying or uncomplicated regurgitation in otherwise healthy infants. Concerns about unnecessary medication exposure and potential adverse effects led to more conservative recommendations.
As a pediatrician, I believe this shift was important.
Babies should not receive medications they do not need, and acid suppression is not an appropriate solution for every feeding or crying problem.
BUT I also believe we need to be mindful of the other side of this conversation.
In trying to prevent over-treatment, we must be careful not to overlook infants who genuinely need further investigation or treatment.
Good medical care requires us to hold both principles at once.
We should avoid unnecessary medication while recognizing that appropriately diagnosed GERD can require medical management. When medication is indicated, I believe it should be selected thoughtfully, monitored for effectiveness and adverse effects, and reassessed regularly. And, when medication is not indicated, families still deserve a meaningful plan to address their concerns.
Being cautious about treatment should never mean being indifferent to suffering.
Why “They'll Grow Out of It” Isn't Always Enough
I know that uncomplicated infant reflux usually improves with age. This is an important part of the reassurance I offer families.
But I also recognize that for parents watching their baby struggle through feeds, become distressed repeatedly, or develop increasingly difficult feeding patterns, being told to wait can feel profoundly inadequate.
There is a difference between reassuring a family that their baby's condition is likely to improve and suggesting that their current concerns do not warrant attention.
A baby who is struggling to feed today still needs support today.
A parent who is worried about their baby's discomfort deserves to understand what might be happening, what warning signs to watch for, and what options are available.
And when symptoms are persistent, worsening, or affecting feeding and growth, further assessment may be necessary.
I don't believe waiting for maturity to resolve reflux should replace investigating symptoms that suggest something more significant may be happening.
Sometimes reassurance is appropriate. Sometimes feeding adjustments are enough. Sometimes an underlying allergy, swallowing difficulty, or another condition needs to be considered. And sometimes GERD requires targeted treatment.
My responsibility as a pediatrician is to help families understand which of these situations may apply to their baby.
Why Comprehensive Reflux Care Matters to Me
I founded Crying, Colic, and Beyond around a belief that has become increasingly important to me throughout my career: families deserve more than a brief assessment of their baby's symptoms and a recommendation to wait.
I believe that caring for babies with reflux requires us to look at the whole baby, rather than treating reflux as an isolated symptom.
When I assess an infant, I want to understand their feeding history, growth, behavior, symptom patterns, and previous treatments. I also want to consider whether other conditions might be contributing to what the family is experiencing.
Could cow's milk protein allergy be playing a role? Are there feeding mechanics or swallowing concerns that need attention? Has the baby developed difficult feeding patterns or signs of feeding aversion? Are there other medical explanations we need to investigate?
These are all important considerations because no two babies experience reflux in exactly the same way.
A baby who cries during feeds may need a very different approach from one who regurgitates frequently but feeds comfortably.
And effective care is rarely as simple as choosing a formula or prescribing a medication.
For some babies, the most appropriate approach involves feeding adjustments and reassurance. For others, it may involve further investigation, carefully considered medication, feeding support, or coordination with other specialists.
My goal is not to diagnose every unsettled baby with reflux or to advocate for medication in every case.
My goal is to understand why a baby is struggling and develop an appropriate, evidence-informed plan that addresses their individual needs.
I also believe that follow-up is an essential part of good care.Infant symptoms can change quickly, and a treatment plan that looks reasonable on paper may need to be revisited as a baby responds.
This is why our consultations at Crying, Colic, and Beyond include ongoing support. I want families to have the opportunity to ask questions, share updates, and receive guidance as their baby's care progresses.
For me, comprehensive care isn't simply about reaching a diagnosis or recommending a treatment. It's about making sure families feel supported throughout the process.
Parents Deserve to Be Part of the Conversation
One of the most valuable things I've learned throughout my career is the importance of listening to parents.
Parents are often the first people to recognize that something isn't right.They're the ones observing their baby's feeding patterns throughout the day and night. They notice subtle changes in behavior, recognize when a previously comfortable feed becomes difficult, and see how symptoms affect their child's daily life.
Those observations are valuable clinical information.
Of course, parental concern alone cannot establish a diagnosis. But I firmly believe it should always be taken seriously as part of the assessment.
At Crying, Colic, and Beyond, we hear from parents who feel that they've exhausted every option, questioned their own instincts, or worried that they're overreacting.
I want those families to know that asking questions is appropriate. Seeking another assessment when symptoms persist is reasonable. And wanting to understand the cause of your baby's distress does not mean you're asking for unnecessary intervention.
I believe good medical care is a partnership. It combines clinical knowledge, current evidence, careful assessment, and the lived observations of the people who know the baby best. When we listen to parents, we gain a more complete understanding of the child in front of us, and that can make an enormous difference in how we approach their care.
Changing the Conversation Around Infant Reflux
We've come a long way in understanding infant reflux, but I believe there's still room for a more thoughtful conversation.
We need to move beyond the idea that reflux is either a harmless developmental phase or a condition that automatically requires medication.
The reality is much more nuanced.
Most babies with reflux will improve without medical treatment. Some will experience symptoms or complications that require a different approach. Others will have difficulties that resemble reflux but are caused by something else entirely.
All of these babies deserve appropriate care.
As a pediatrician, I believe taking infant reflux seriously means neither minimizing symptoms nor overmedicalizing normal infancy. It means listening carefully, asking the right questions, recognizing when something warrants further attention, and supporting families through the process.
This philosophy is at the heart of why I founded Crying, Colic, and Beyond, and it continues to guide the care we provide every day.Because while reflux may be common, every baby's experience is individual. And because “they'll grow out of it” should never be the end of the conversation when a baby is genuinely struggling.
How We Can Help
If your baby is struggling with suspected reflux, GERD, persistent crying, or feeding difficulties, my team and I are here to help.
At Crying, Colic, and Beyond, I offer comprehensive telehealth consultations focused on understanding your baby's symptoms, reviewing their medical and feeding history, and developing an individualized care plan. Our consultations include three weeks of ongoing chat support with our medical team, so families have continued guidance as they navigate their baby's care.
You can contact us at info@cryingcolicandbeyond.com to learn more about our services and appointment availability, or read more about our consultation options and book in directly here.
Dr. Jennifer Harris is a board-certified pediatrician and the founder of Crying, Colic, and Beyond, a pediatric telehealth practice specializing in infant reflux, colic, food allergies and intolerances, and feeding difficulties.
This article is intended for educational purposes and does not replace individualized medical advice. Persistent feeding difficulties, poor weight gain, or significant distress warrant medical assessment.
References
Rosen, Rachel, et al. “Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of NASPGHAN and ESPGHAN.” Journal of Pediatric Gastroenterology and Nutrition 66, no. 3 (2018): 516–554. https://doi.org/10.1097/MPG.0000000000001889
National Institute for Health and Care Excellence. Gastro-Oesophageal Reflux Disease in Children and Young People: Diagnosis and Management. NICE Guideline NG1. 2015, updated 2019. https://www.nice.org.uk/guidance/ng1
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