Red flags & when to go in person for Acid Reflux (GERD) in Children

Audience: pediatric

Acid reflux, also known as gastroesophageal reflux disease (GERD), happens when stomach acid flows back into the esophagus, causing discomfort. In children, GERD can cause symptoms like spitting up, vomiting, coughing, or trouble swallowing. Many cases improve with simple care and lifestyle changes. However, some signs mean your child needs to see a healthcare provider in person. These include severe pain, trouble eating or breathing, or symptoms that do not improve with treatment. Telemedicine can help you understand symptoms and get advice on managing mild GERD. But if your child shows danger signs, an in-person visit is important to ensure proper care. This guide helps parents and caregivers know when to seek in-person care and what to expect from telemedicine visits for pediatric acid reflux.

Red flags — go in person / ER

• Difficulty breathing or noisy breathing — seek urgent in-person care immediately.
• Persistent vomiting, especially if vomiting blood — go to emergency care.
• Refusing to eat or drink for more than a few hours, signs of dehydration — see a healthcare provider promptly.

What telemedicine can do

• Assessment of mild GERD symptoms in children.
• Providing advice on feeding and lifestyle changes.
• Guidance on over-the-counter treatments and symptom monitoring.
• Education on when to seek in-person care.

What telemedicine cannot do

• Physical examination or diagnostic testing (e.g., endoscopy).
• Management of severe symptoms like breathing difficulty or dehydration.
• Emergency care for red flag symptoms.
• Treatment of complications such as esophageal damage.

What is Pediatric Acid Reflux (GERD)?

Acid reflux occurs when stomach acid flows back into the esophagus, the tube connecting the mouth and stomach. In children, this can cause spitting up, vomiting, coughing, or irritability after feeding. GERD is a more serious form of reflux that happens often and can cause discomfort or damage to the esophagus. Many infants experience mild reflux that improves as they grow, but some children may need medical care to manage symptoms.

Common Symptoms of GERD in Children

Children with GERD may have:

These symptoms often improve with simple changes like feeding adjustments or positioning.

Red Flags: When to Seek In-Person Care

Certain signs mean your child should be seen by a healthcare provider in person as soon as possible:

If you notice any of these, seek urgent medical attention.

How Telemedicine Can Help

Telemedicine visits allow you to speak with a healthcare provider from home. For mild GERD symptoms, telemedicine can:

However, telemedicine cannot perform physical exams or tests needed for severe cases.

Preparing for a Telemedicine Visit

Before your telemedicine appointment:

This preparation helps the provider give the best advice.

After the Telemedicine Visit

After your telemedicine appointment:

Regular follow-up may be needed to manage GERD effectively.

How to prepare for your tele-visit

• Note the child’s symptoms, including timing and frequency.
• List any current medications or supplements.
• Prepare to describe feeding habits and recent changes.
• Ensure a quiet, well-lit space with good internet for the tele-visit.
• Have a caregiver present to help if needed.

After your tele-visit

• Follow all provider recommendations carefully.
• Monitor the child’s symptoms and feeding closely.
• Schedule an in-person visit if symptoms worsen or do not improve.
• Keep track of the child’s weight and growth progress.
• Seek emergency care if any red flag symptoms develop.

FAQs

What causes acid reflux in children?

Acid reflux happens when the muscle at the bottom of the esophagus doesn’t close properly, allowing stomach acid to flow back up. In infants, this muscle is often immature. Other causes include overeating, certain foods, or medical conditions.

Can acid reflux harm my child?

Most children with mild reflux do well and outgrow it. However, frequent acid reflux can irritate the esophagus and cause discomfort or feeding problems. That’s why monitoring symptoms and seeking care when needed is important.

How can I help my child at home?

Try feeding smaller amounts more often, keep your child upright after feeding, avoid foods that trigger reflux, and ensure they maintain a healthy weight. Always follow your healthcare provider’s advice.

When should I worry about my child’s reflux?

If your child has trouble breathing, persistent vomiting, refuses to eat or drink, shows signs of dehydration, or has severe pain, seek medical care promptly.

Is medication always needed for pediatric GERD?

Not always. Many children improve with lifestyle changes alone. Sometimes medications are recommended to reduce stomach acid or protect the esophagus, but this should be decided by a healthcare provider.

Sources

1. Gastroesophageal Reflux in Children — MedlinePlus, U.S. National Library of Medicine.
2. Gastroesophageal Reflux Disease (GERD) in Children — American Academy of Pediatrics.
3. GERD in Infants and Children — Mayo Clinic.
4. Gastroesophageal Reflux Disease (GERD) — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or any red flags, please seek immediate medical attention.