How do I know if my baby has reflux?

What the evidence says

Spitting up is extremely common in young babies — up to half of babies spit up multiple times a day in the first few months, and this on its own is not a disease. These 'happy spitters' feed well, gain weight normally, and aren't bothered by the spit-up.

Reflux becomes a concern (sometimes called GERD) when it causes real trouble: poor weight gain or fewer wet/dirty diapers, frequent forceful or projectile vomiting, arching the back or crying a lot during or after feeds, refusing to feed, choking, gagging, wheezing, or breathing problems. Blood in the spit-up or stool, or vomit that is green/yellow, is not normal and needs prompt medical attention.

Doctors usually diagnose reflux just from your description of symptoms and a physical exam — special tests are only used if symptoms are severe, don't improve with simple changes, or another condition is suspected. It's also worth knowing that ordinary newborn crying and colic are common too, and are not caused by reflux and don't respond to heartburn medicines.

If your baby is under 1 month old and having true forceful vomiting, or if you're worried about weight gain, feeding refusal, or breathing symptoms, contact your pediatrician or family doctor to get things checked out properly.