Pediatric GERD/ GER

Although speech-language pathologists and occupational therapists do not treat the underlying medical cause of GERD, they play an important role in helping children who develop feeding challenges because of reflux.

At Therapy Smarts, our pediatric feeding specialists can help children:

• Build positive experiences around eating
• Reduce food aversions
• Improve oral motor skills
• Safely introduce new textures and foods
• Increase food variety
• Improve chewing and swallowing skills when appropriate
• Support successful transitions from bottle to cup and solids
• Create individualized home strategies for families

Our therapists work closely with your child’s pediatrician and other medical providers to ensure feeding therapy complements medical treatment.

Yes. While GER (gastroesophageal reflux) and GERD (gastroesophageal reflux disease) are medical conditions that should be diagnosed and managed by a pediatrician or pediatric gastroenterologist, some children develop developmental or feeding challenges that can benefit from therapy. The type of therapy depends on how reflux is affecting the child.

Speech Therapy (SLP)

Speech-language pathologists are often the primary therapy providers for children with GERD-related feeding difficulties.

A child may benefit from speech therapy if they have:

• Difficulty breastfeeding or bottle feeding
• Choking, coughing, or gagging during meals
• Difficulty swallowing (dysphagia)
• Oral motor weakness affecting chewing or drinking
• Food refusal because eating has become painful
• Limited food variety or extreme picky eating after experiencing reflux
• Difficulty transitioning to purees or solid foods
• Poor coordination of sucking, swallowing, and breathing in infants

Speech-language pathologists can:

• Evaluate feeding and swallowing skills
• Improve oral motor coordination
• Increase chewing efficiency
• Help children safely progress to age-appropriate foods
• Reduce food aversions through positive feeding strategies
• Teach families techniques for more successful mealtimes
• Collaborate with physicians and dietitians to support overall nutrition

Occupational Therapy (OT)

Occupational therapists can help when reflux has affected a child’s sensory processing or participation in mealtimes.

A child may benefit from OT if they:

• Have strong sensory reactions to food textures, temperatures, or smells
• Become anxious or distressed at mealtimes
• Refuse to sit at the table
• Have difficulty with self-feeding skills
• Experience poor body awareness or posture that impacts eating
• Need support with daily routines surrounding meals

Occupational therapists can:

• Address sensory sensitivities related to eating
• Improve posture and positioning during meals
• Build self-feeding skills
• Develop calming strategies for anxious eaters
• Help create positive, low-stress mealtime routines

Physical Therapy (PT)

Physical therapy is less commonly needed specifically for GERD, but it may be appropriate if reflux is contributing to delays in movement or if a child has an underlying medical condition affecting both mobility and feeding.

A child may benefit from PT if they:

• Have delayed gross motor milestones
• Have poor core strength affecting posture during feeding
• Have torticollis or positioning challenges
• Need help developing sitting balance for safe feeding
• Have neurological or genetic conditions where reflux is one of several concerns

Physical therapists can:

• Improve head, neck, and trunk control
• Strengthen core muscles for better sitting posture
• Promote age-appropriate motor development
• Recommend positioning strategies that support comfortable feeding