Which of the following is NOT a listed GERD complication in infants?

• A. Weight loss or failure to thrive
• B. Feeding difficulties
• C. Arching of the back
• D. Joint hypermobility

Answer: (D)

Infants with GERD tend to show issues related to feeding and growth, plus certain posturing that reflects esophageal irritation. Feeding difficulties are common because reflux can make feeding uncomfortable, leading to pauses, irritability, and overall poor intake. Weight loss or failure to thrive signals insufficient nutrition or higher energy use from reflux symptoms. Arching of the back is a classic sign known as Sandifer syndrome, where posturing relieves esophageal discomfort.

Joint hypermobility, on the other hand, is a connective tissue trait and is not a described complication of GERD in infancy. It does not arise from reflux symptoms, so it wouldn’t be expected as a GERD-associated finding. Therefore, joint hypermobility is the correct choice as not being a listed GERD complication in infants.