Acid reflux is basically when stomach contents are backing up into the throat. It is also known as gastroesophageal reflux (GER). This is an illness that both adults and infants can experience. An infant that suffers from the disease will frequently vomit or spit up.
There is another type of condition known as GERD (gastroesophageal reflux disease). Usually, infants will have feeding difficulties, choking, coughing, improper weight gain, wheezing after feeding and irritability if they are experiencing this condition. Also, GERD is basically GER but just more complicated. However, infants experience GER much more often than GERD. Baby reflux treatment usually depends on the severity of the problem and your child’s age. Usually, the best place to start is a simple home care and lifestyle changes.
Symptoms to Look For
GER is a condition that’s usually considered uncomplicated. People refer to infants that experience GER “happy spitters”. Children that experience this condition often experience vomiting, refused or prolonged feeding, back arching, and irritability. In addition, infants that suffer from GERD may also experience frequent vomiting, difficulty swallowing and refusing to eat.
Usually, baby reflux symptoms are very easy to notice but you need to know how to distinguish symptoms caused by GER from GERD.
Children with GER will have normal weight gain and little to no difficulties with feedings. Also, no neurobehavioral symptoms should be present a well as any significant respiratory problems. If your baby has none of these symptoms it is probably experiencing GER and you don’t need to worry too much.
In contrast, infants with GERD have different symptoms which are usually very easy to notice. Weight loss, poor weight gain, and failure to thrive are the first things to look for if you are suspecting on GERD. Also, lengthy feedings or refusing to feed are also common symptoms pointing at the condition. Your baby might experience irritability after eating which you will notice easily. Pain or difficulty when swallowing are common baby reflux symptoms too, as well as frequent vomiting.
Abdominal and chest pain may occur frequently if your baby is experiencing GERD. Asthma, wheezing, hoarseness and long-term coughing are some of the other symptoms that are common.
Sinusitis, pneumonia, inflammation of the middle ear, laryngitis that reoccurs may all be signs of GERD in infants. Since infants are not able to tell us where they feel the pain you need to look for signs. These signs will usually show in a form of sleep disturbances, decreased appetite, excessive crying episodes, and distress.
You need to consult with your doctor if you notice any of these symptoms of GERD. Usually, the symptoms won’t be caused by GERD but by some other condition that shares the same symptoms. Also, baby reflux treatment is pretty straightforward so you won’t have to worry even if GERD is causing them.
Baby Reflux Causes
The esophageal sphincter is a muscle at the lower end of the food pipe. The role of this muscle is to contract to stop acid and food backing up into the food pipe and relax to let food into the stomach. When this muscle is not closed entirely, the liquids from the stomach will go back into the food pipe. This happens to all people sometimes. However, infants under the age of 1 year are more likely to experience it.
Sometimes, GER will go unnoticed, mainly because the liquid is vomited, or if it remains in the lower food pipe. This kind of regurgitation is very common in young children and is most present when infants turn 3-4 months of age. There are infants who will have reflux maybe once in a day, while others regurgitate with almost every feeding.
By the time an infant is about 18 months old, this muscle that controls the food flow will mature and regurgitation rate will decline.
As already mentioned, GERD is a more serious condition than GER but is more common among adults than infants. However, it sometimes happens in infants too and may cause complications and troublesome symptoms. Symptoms such as irritability, sleep disturbances, unexplained crying, and slow weight gain are very common. It is important to treat GERD so the condition doesn’t do any tissue damage to the food pipe of your child.
Sometimes, baby reflux symptoms may be present due to more serious conditions such as:
- Pyloric stenosis – a condition that doesn’t allow food to flow into the small intestine.
- Eosinophilic esophagitis – white blood cells that might injure or inflame the esophagus tissue
- Food intolerance
Diagnosing Baby Reflux
Typically, doctors won’t do any diagnostic tests when diagnosing reflux. It is not proven that diagnostic tests are giving better results than a doctor carrying out a physical examination and asking questions. No further tests will be required if the baby seems content, appears healthy and grows as expected.
In some rare cases, doctors will use some diagnostic tests. Usually, this will happen if there are lung problems present, if there’s no weight gain, and if the overall symptoms do not improve over time.
These tests are usually compiled of blood and urine tests, ultrasound, X-rays, esophageal pH monitoring, biopsy, and endoscopy.
Treating Baby Reflux
Usually, reflux or regurgitation problems will resolve after the first year of your baby’s life. Also, baby reflux treatment won’t be required in most cases.
Reflux is a lot less severe and less frequent in breastfed babies. Reducing the feeding volumes for infants that use baby bottle may improve reflux problems. Also, changing your overall lifestyle, as well as the lifestyle of your baby may significantly help. Interrupt feedings frequently and try to burp your baby.
If your child is on a baby formula there are a couple of things you can do to improve infant reflux. First, as already mentioned, reduce feeding volumes. Feeding smaller amounts, but more frequently, may considerably help too. If your doctor approves, you can try adding a teaspoon of rice cereal to your baby’s formula (per ounce).
There are also antireurgitant formulas available, so you can try some of these too. Hypoallergenic formulas are available too and they are made specifically for infants that are lactose intolerant (milk protein allergy).
When it comes to breastfed babies, eliminating eggs and cow’s milk from the mom’s diet may significantly improve reflux symptoms.
A good practice is to lay your child on its tummy or on its left side after feedings while the child is still awake. However, it is recommended that infants should always sleep on their back due to the potential risks of SIDR (sudden infant death syndrome).
Elevating diaper-changing tables and crib have also shown as a good practice that prevents reflux symptoms. The elevation should be about 30 degrees. Also, keeping your child in an upright position for about 30 minutes after feedings might also reduce symptoms.
Children with uncomplicated reflux shouldn’t be taking any medications. Medications for reflux might develop unwanted symptoms. Sometimes, this medication prevents calcium and iron absorption in infants and it also increases the risk of intestinal and respiratory infections.
Positional and feeding changes should usually improve GERD. However, if your infant still has a problem with growth, sleeping, or feedings, your baby’s doctor might recommend some medication that will decrease acid in your baby’s stomach.
Proton pump inhibitors and H2 blockers are some of the medication that might be prescribed. They help to ease the symptoms of GERD because they lower the production of acid in the stomach. This also helps to heal the food pipe. Proton pump inhibitors are usually prescribed for long-term GERD treatment while H2 blockers are usually used for short-term.
Infant GERD may be treated by surgical procedures too. However, this is only considered in severe cases when no medication is helping or if there are other serious complications due to GERD.
Potential Risk Factors
Usually, risk factors regarding GER in infants are unavoidable and these are:
- Short food pipe
- Frequent large-volume feedings
- Lower esophageal sphincter relaxation after feedings
- Laying down
When it comes to GERD, there are many conditions that might raise the risk for the disease, such as:
- Premature birth
- History of reflux in the family
- Neurodevelopmental disorders
- Hiatal hernia
- Cystic fibrosis
Baby Planet Overview
Baby reflux is a common condition and your infant is more likely to experience it than not. However, infants usually experience GER and there are not many reasons why you should be worried about it. The treatment is very straightforward and the symptoms are obvious. GERD is a condition more common in adults, but some infants might also experience it. But, this is also not a reason for panic.
GERD, if not treated, may cause some damage to the tissue of the food pipe. It can also be a reason for other serious condition. Fortunately, modern medicine has treatment methods and medicine that help with baby reflux that will certainly help your child. Your job as a parent is to recognize the symptoms and take your baby to a doctor. The doctor will do the examination and decide on the best remedy for your little one.
- Gastroesophageal reflux disease in neonates and infants: when and how to treat. , ncbi.nlm.nih.gov