ANSWER:
I’ll give the same answer I gave on another question:

Technically, the only way to officially diagnose reflux is a GI probe test, which is extremely invasive, especially for an infant, so most doctors make a unofficial diagnosis based on symptoms. Here’s a list of reflux symptoms in infants: http://heartburn.about.com/od/infantschildrenandreflux/qt/infantgerdsympt.htm

Be aware that excessive spitting up, or spitting up in general, is *not* the same as reflux. All babies spit up at some point or another, and some spit up a lot, but reflux is not always the cause. Reflux, or GERD, occurs when the valve that separates the stomach from the esophagus doesn’t close completely after a feeding, causing stomach acids and food (or, in a baby’s case, milk) to come back up. This often causes damage to the esophageal wall as well, as stomach acids are extremely corrosive. This is why true reflux or GERD can only truly be diagnosed by a GI probe test. The probe searches the esophagus for damage and checks to see if the valve doesn’t close properly.

Spitting up is sometimes a symptom of reflux, obviously, since milk will come back up if the valve doesn’t close completely, but there are many other possible causes of spitting up: oversupply or overactive letdown, excessive swallowing of air during feeding, pyloric stenosis, allergies (sometimes food allergies or sensitivities, such as a dairy allergy), or sometimes overeating/overfeeding. Many of these issues are mistakenly diagnosed as reflux, when they’re not reflux at all. Often, they’re easily fixable with dietary changes, altering feeding methods or positions, or, in the case of pyloric stenosis, surgery would be required. Babies can also have what’s known as silent reflux – reflux without the obvious symptom of frequent spitting up. So, spitting up isn’t always an accurate indicator of reflux. They’re two completely different things.

Personally, I think it’s best to try solutions for some of the problems listed above before resorting to prescription medications for reflux. If the baby is breastfed, block feeding, eliminating dairy, and altering feeding positions can help eliminate the issues. If the baby is formula fed, sometimes changing formulas can help, specifically if it’s suspected that the baby has a dairy allergy or sensitivity. You might consider talking to your doctor about testing for allergies as well, before trying any reflux medications.

Chiropractic care is also shown to help reflux, or other issues that mimic reflux. Chiropractic adjustments help body stay in proper alignment, which can aid in proper digestion and help reduce the symptoms of reflux, colic, allergies, and other issues. Here’s more info on chiropractic care for reflux: http://www.infantrefluxdisease.com/forums/showthread.php?t=46045 This is a very detailed report on how chiropractic care helped infants with reflux and similar issues: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597889/

Be aware that many doctors still recommend adding rice cereal to an infant’s diet in order to help reflux. This is actually not proven to lower reflux index scores or heal esophageal damage. It’s basically a bandage that can occasionally help a symptom of a problem, but the underlying issue (silent reflux) will still persist. Here’s a link to an article that references a study on thickening feeds with cereal to treat reflux: http://www.hini.org/HINI/pdfs/InTouchVol18_2.pdf and another: http://www.ncbi.nlm.nih.gov/pubmed/3806288?dopt=Abstract In some cases, the rice cereal made the reflux worse.

In other words, treating reflux with rice cereal is like treating a broken bone with Vicodin. The Vicodin will help the pain – a symptom of the broken bone – but the bone will still be broken. Personally, I would avoid thickened feeds, given that there are no known benefits, and actually some risks. Introducing solids before an infant is developmentally and biologically ready (which is around 6 months of age, based on the medical evidence we have now), can lead to digestive issues, allergies, iron deficiency anemia later in life, and other issues: http://www.kellymom.com/nutrition/solids/delay-solids.html

Overall, if your baby is wetting adequate diapers and gaining weight, it is likely more of a laundry issue than anything else.

Here’s a good page on reflux. A lot of the information is directed toward breastfed babies, but most of it will apply to formula fed babies as well: http://www.kellymom.com/babyconcerns/reflux.html