My fourth child, an eight-year-old boy, was diagnosed (at 18 months) with GERD.  He was breastfed exclusively for 6 months and weaned at 1 year.  Looking back on that first year, the only GERD symptoms I can identify were vomiting if he coughed while nursing.  I seemed like a gag reflex.  He never spit up and seldom burped.  He was a big, healthy, happy baby. 

At about 15 or 16 months, I remember his throwing up, yet not seeming sick.  Of course, I kept him away from others for a day or so, not to expose other children to the flu.  About a week later, the same thing happened.  Another week passed, and he was sick--again with no other flu symptoms.  Then, instead of once weekly vomiting, it became every few days.  When it reached once a day, I finally went to the pediatrician.  My son was diagnosed then with GERD and was given Zantac which cleared his symptoms almost immediately.  We also limited the grapefruit/orange sections, the Hawaiian pizza, and the tomato soup that had seemed to almost immediately induce vomiting.  After a couple months, I stopped giving him the medicine at the suggestion of my doctor and only medicated him when his symptoms "flared." 

As he has grown, he's been both easier and harder to treat.  Easier because he's growing up, can talk, is getting bigger, vomits into a toilet, etc.  Harder because we no longer live across the street from a children's hospital.  Instead, we're traffic hours away, the doctors keep changing, each new specialist wants to observe and start over, or it takes months to get the appointment, then diagnostic equipment breaks . . .  Anyway, it seems to not bother him except once a year when the reflux flares, he starts wheezing and coughing (sounding like a chronic smoker), coughing so hard he vomits (a pattern for him), and he ends up with bronchitis/pneumonia.  This year--the first exception--he passed through winter unscathed.  Still, I worry.  

Frankly, my son is a highly gifted, intense and behaviorally challenging child.  Doctor's offices are understandably torturous for the both of us.  As a result, I tend to avoid them. Then I think of my mother with her almost bi-monthly esophageal dilation and her "snacks" of baby rice cereal (one of the few things that doesn't cause her pain to eat), and I'm consumed with guilt.  

Is my determination to avoid doctor's office trauma for us both actually hurting him?  Have I erred in my quest to keep a young child off powerful medications?  Is there an effective, natural remedy besides limiting acidic foods?  Is long-term damage being done even when he's not presenting classic GERD symptoms?  Is there a specialist in the greater San Francisco Bay area (we live in Tracy, CA) you would recommend and a specific course of action to try?