Version July 2025
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What are discharge instructions? —
Discharge instructions are information about how to take care of your baby after getting medical care in the emergency department ("ED").
What should I know? —
Your baby was seen in the ED for acid reflux. This is when the acid that is normally in the stomach backs up into the esophagus. When acid reflux causes bothersome symptoms or damage, it is called "gastroesophageal reflux disease" ("GERD").
Acid reflux is common and usually harmless in babies. It can cause frequent spitting up. If your baby spits up a lot, but seems otherwise happy and healthy, they probably have "uncomplicated reflux." If they have symptoms like refusing to eat, crying and arching their back, choking, vomiting forcefully, or not gaining weight, they might have GERD.
The doctor thinks it is safe for you to treat your baby's acid reflux at home.
How do I care for my baby at home? —
Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for your baby. Ask questions if there is anything you do not understand.
You should also do the following:
●Call your baby's regular doctor and tell them your baby was in the ED. Make a follow-up appointment if you were told to.
●Give your baby all their medicines as instructed. These might include antacids, histamine blockers, or proton pump inhibitors ("PPIs"). Some of these are available without a prescription. Do not give your baby any medicine without talking to their doctor first.
●Hold your baby upright for 20 to 30 minutes after a feeding. Burp them often. Putting them in an infant seat (such as a car seat) right after feeding does not help with reflux. Sitting can push the legs up and put pressure on their belly. This can actually make reflux worse.
●Ask your baby's regular doctor if you should try removing milk or soy from their diet. Also ask if you should thicken their milk or formula.
●Always put your baby to sleep on their back, not on their side or belly. This is the safest position for sleep, whether or not they spit up.
●Do not smoke or vape around your baby. Do not let them be in places where people are smoking or vaping.
When should I get emergency help?
●Call for emergency help right away (in the US and Canada, call 9-1-1) if:
•If your baby has sudden severe belly pain, or constant belly pain.
•If your baby's belly is hard or swollen.
●Return to the ED if you baby:
•Cannot keep any fluids down, has not had anything to drink in many hours, and has 1 or more of these:
-They are not as alert as usual, are very sleepy, or are much less active than normal.
-They are crying all the time.
-They do not have a wet diaper for over 8 hours.
-Their skin is cool.
•Vomits blood, or their vomit is black, bright yellow, or green or looks like coffee grounds
When should I call the doctor? —
Call for advice if:
●Your baby does not want to eat, or is losing weight without trying.
●Your baby is having trouble feeding normally.
●Your baby has a dry mouth.
●Your baby has few or no tears when they cry.
●Your baby's urine is dark.
●Your baby is less active than normal.
●Your baby vomits more forcefully and more often than usual.
●Your baby cries for longer than 2 hours straight.
●Your baby has new or worsening symptoms.
Patient education: Spitting up and GERD in babies (The Basics)
Patient education: Acid reflux (gastroesophageal reflux) in babies (Beyond the Basics)
