A 9-month-old infant with a diagnosis of gastroesophageal reflux (GER) is being discharged from the hospital.The nurse is educating the parents about signs of possible complications related to GER.Which of the following signs should the parents report immediately to the pediatrician?

Choice A rationaleIrritability after feedings can be a common symptom of GER due to stomach acid refluxing into the esophagus and causing discomfort. While it should be reported, it is not necessarily an immediate sign of a serious complication.Choice B rationaleA slight decrease in appetite can occur with GER due to discomfort or a learned aversion to feeding. While it warrants monitoring, it is not typically an immediate red flag for severe complications.Choice C rationaleCoughing or wheezing during sleep can indicate aspiration of gastric contents into the airway due to severe GER. Aspiration can lead to respiratory complications such as pneumonia, making this a serious sign that requires immediate medical attention.Choice D rationaleOccasional spitting up after feedings is a common manifestation of GER in infants and is often physiological. While frequent or forceful spitting up should be monitored, occasional spitting up in a 9-month-old with known GER is not necessarily a sign of a serious complication requiring immediate reporting.