Reflux in Infants...Spit Happens

As the mother of a cyclic vomiter and chronic refluxer and as a feeding therapist who has worked with a pedi GI for a decade...I know something about this subject. How do you know reflux is a problem or not?
Signs of uncomplicated reflux, the baby refluxes, but is a "happy spitter"
Random spitting-5 minutes or 2 hours after a feeding. In infants, the lower esophageal sphincter is not mature yet and it opens in a random manner. If there is something in the stomach, it will come up. Remember, the stomach has gastric juices in it, it doesn't "empty" like pouring liquid out of a bowl. Many times, people think a baby has spit up a huge amount of a feeding and actually it is not as much as it seems.
Good health, no significant respiratory history
Good weight gain
No feeding refusals-this means that the baby is likely not experiencing pain from esophagitis while feeding

Complicated Reflux...in other words, needs some form of treatment
Blue spells, apnea, respiratory complications
Poor weight gain
Feeding refusals
Pain signs while feeding
Patterned reflux (example: baby spits up 30 minutes after feeding on a consistent basis, Luke had cyclic spells every 6-12 weeks, this is a pattern as well)
Vomiting at night
Gagging (reflux related)
Eczema or rashes
Enamel changes

What can you do to help? Elevated bed while sleeping, making sure the baby is being fed the correct amount each day and not over fed, a bottle that does not lead to excessive air intake while feeding (try a Dr. Brown bottle), pacifier that seals the mouth well. If there are signs of complicated reflux, the baby should be seen by a pediatric GI for assessment. The doctor will determine if medicine is needed or if it is already prescribed, he will see if is the dosage correct. There also may be additional tests needed to further evaluate reflux/vomiting.