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Rome IV Diagnostic Criteria for Infant Regurgitation
Symptom-based diagnosis of uncomplicated 'happy spitting' in a healthy infant.
Rome IV Diagnostic Criteria for Infant Regurgitation
Otherwise healthy infant, 3 weeks to 12 months of age
Regurgitation ≥2 times per day for ≥3 weeks
No retching, hematemesis, aspiration, apnea, failure to thrive, feeding or swallowing difficulty, or abnormal posturing
ResultCriteria not met
Does not meet Rome IV criteria for infant regurgitation; evaluate for GERD with complications or another cause of vomiting.
When to use
- Thriving infant with frequent effortless spitting up and no warning signs, to distinguish physiologic regurgitation from pathologic GERD.
Formula
Diagnosis requires all of: otherwise healthy infant aged 3 weeks to 12 months; regurgitation ≥2 times/day for ≥3 weeks; absence of retching, hematemesis, aspiration, apnea, failure to thrive, feeding/swallowing difficulty, or abnormal posturing.
Pearls and pitfalls
- Presence of any warning sign (poor weight gain, blood in emesis, respiratory symptoms) shifts the differential toward pathologic GERD or another diagnosis.