Chalasia, Infant

Your baby's spitting up is most likely caused by a condition called chalasia or gastroesophageal reflux. It happens because, as in most babies, the opening between your baby's esophagus and stomach does not close completely. This causes your baby to spit up mouthfuls of milk or food shortly after a feeding. This is common in infants and improves with age. Most babies are better by the time they can sit up. Some babies may take up to 1 year to improve. On rare occasions, the condition may be severe and can cause more serious problems. Most babies with chalasia require no treatment. A small number of babies may benefit from medical treatment. Your caregiver can help decide whether your child should be on medicines for chalasia.

SYMPTOMS

An infant with chalasia may experience:

  • Back arching.

  • Irritability.

  • Poor weight gain.

  • Poor feeding.

  • Coughing.

  • Blood in the stools.

Only a small number of infants have severe symptoms due to chalasia. These include problems such as:

  • Poor growth because they cannot hold down enough food.

  • Irritability or refusing to feed due to pain.

  • Blood loss from acid burning the esophagus.

  • Breathing problems.

These problems can be caused by disorders other than chalasia. Your caregiver needs to determine if chalasia is causing your infant's symptoms.

HOME CARE INSTRUCTIONS

  • Do not overfeed your baby. Overfeeding makes the condition worse. At feedings, give your baby smaller amounts and feed more frequently.

  • Some babies are sensitive to a particular type of milk product or food. When starting new milk, formula, or food, monitor your baby for changes in symptoms. Talk to your caregiver about the types of milk, formula, or food that may help with chalasia.

  • Burp your baby frequently during each feeding. This may help reduce the amount of air in your baby's stomach and help prevent spitting up. Feed your baby in a semi-upright position, not lying flat.

  • Do not dress your baby in tightfitting clothes.

  • Keep your baby as still as possible after feeding. You may hold the baby or use a front pack, backpack, or swing. Avoid using an infant seat.

  • For sleeping, place your baby flat on his or her back. Raising the head end of the crib works well. Do not put your baby on a pillow.

  • Do not hug or play hard with your baby after meals. When you change your baby's diapers, be careful not to push the baby's legs up against the stomach. Keep diapers loose.

  • When you get home from your caregiver visit, weigh your baby on an accurate scale and record it. Compare this weight to the weight from your caregiver's scale immediately upon returning home so you will know the difference between the scales. Weigh your baby and record the weight daily. It may seem like your baby is spitting up a lot, but as long as your baby is gaining weight properly, additional testing or treatments are usually not necessary.

  • Fussiness, irritability, or colic may or may not be related to chalasia. Talk to your caregiver if you are concerned about these symptoms.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your baby starts to vomit greenish material.

  • The spitting up becomes worse.

  • Your baby spits up blood.

  • Your baby vomits forcefully.

  • Your baby develops breathing difficulties.

  • Your baby has an enlarged (distended) abdomen.

  • Your baby loses weight or is not gaining weight properly.