The main clinical manifestations in the neonatal period are acute symptoms of the respiratory, circulatory and digestive systems simultaneously, but respiratory symptoms are the prominent manifestations. Dyspnea, shortness of breath, and cyanosis may begin after birth or appear within a few hours after birth. Dyspnea and cyanosis may be paroxysmal and variable, i.e., they may worsen during crying or feeding, or they may worsen suddenly and progressively. The common clinical manifestations are as follows: 1. Vomiting: the most common symptom in full-term newborns, infants and older children, accounting for more than 80% to 95% of cases, which can occur in the first week after birth. Vomiting in a variety of forms, often in a lying position or at night for the heavy, sometimes slightly present overflowing milk, serious jet vomiting. Vomiting of coffee-like liquid or vomiting of blood may occur, but not in large amounts. The vomit is initially stomach contents and in severe cases bile, often due to lower esophageal reflux esophagitis. If you can often maintain a semi-sitting position or feeding in, viscous diet, vomiting significantly improved, after 8 to 9 months of illness, the number of vomiting decreased, may be the condition is better, but also may be the lower esophagus fibrosis formed scar stenosis. 2. Para-esophageal hernia: Sometimes the combination of esophagus and stomach remains in the normal position in the abdominal cavity, with part of the fundus herniated into the thoracic cavity or twisted herniation to the right side of the diaphragm occurs. If the twist is too long, it becomes embedded. An obstructive form appears with retrosternal pain, chest tightness, and shortness of breath. Poor gastric venting causes retention gastritis, ulcers, and bleeding. 3. Difficulty in swallowing: Difficulty in swallowing often occurs, which can be improved by fasting and anti-inflammatory treatment in the early stage and then cannot eat or vomit white mucus in the late stage. Reflux esophagitis in sliding esophageal hiatal hernia gradually worsens and inflammation has invaded the muscular layer, causing fibrosis of the lower end of the esophagus, resulting not only in esophageal shortening and herniation of the cardia fundus into the thoracic cavity, but also esophageal stricture. 4, vomiting blood, blood in the stool: vomiting serious children in addition to vomiting coffee-like material, but also appear vomiting blood, discharge of tarry stool and black stool. Prolonged vomiting and blood in the stool are caused by reflux esophagitis, insufficient nutritional intake, and the child appears anemic, with hemoglobin often ranging from 80 to 100 g/L. Length and weight are often lower than those of children of the same age, resulting in poor growth and development. Most stool tests are often positive for occult blood. 5, cough, shortness of breath and other respiratory tract infection symptoms: 30% to 75% of infants and children with esophageal hiatus hernia are diagnosed with recurrent respiratory tract infections because some children have a very small amount of gastric contents that are not usually detected and often repeatedly inhaled into the trachea, forming recurrent respiratory tract infections; although the respiratory tract infections can improve with anti-inflammatory treatment, they cannot be cured. In some allergic children, a small amount of gastric contents is mistakenly inhaled into the trachea, resulting in allergic asthma-like attacks.