​GERD occurs when GER is associated with complications such as inflammation of the food pipe (oesophagitis).

​The most common symptom is vomiting after feeding. Your baby may also present with symptoms that suggest pain and discomfort such as crying and fussing, refusing milk feeds or when the spit up contains blood streaks.

​GER can usually be diagnosed by doctors based on your baby's symptoms. A consultation with a paediatrician specialising in gastroenterology may be needed if your baby has atypical symptoms.

Investigations including 24-hour pH impedance monitoring, upper gastrointestinal contrast study and endoscopy may be performed after an assessment.

As majority of infants with GER improve with time, investigations are not necessary. The doctor spends much of the consultation reassuring the caregiver. Switching to a hydrolysed formula may be beneficial if your child is intolerant or allergic to cow's milk protein.

First-line medications usually include an acid suppressant agent with the addition of a prokinetic agent. Surgery for fundoplication and insertion of gastrostomy feeding tube can be discussed with the paediatric surgeons, especially in cases whereby the child is neurologically-impaired, has persistent failure to thrive or recurrent aspiration etc.

​If your baby is happy, feeding well and putting on weight well, there is no reason to worry and no need for medications. However, if the vomiting is associated with a lot of crying, fussing, arching, turning away (feed refusal) and decreased feeding (less than what is expected of a child of any given age or weight), this would be a cause for concern. If your child does not undergo treatment, he or she will refuse feeding and his or her weight gain will be affected.