FundoplicationFundoplication is a surgical procedure for treating GERD (gastroesophageal reflux disease). The procedure is to help GERD symptoms including heartburn. Eighty percent of patients with GERD also have a hiatal hernia, and during the fundoplication procedure, the hernial sac may also be surgically fixed. The procedure can be done with laparotomy, thoracotomy, or laparoscopy. Children who experience GERD symptoms also have a favorable prognosis though it may require longer use of medications and utilization of life style changes for many months.
LES strength takes time to develop over the first year, so many infants naturally spit up often.
In the meantime, if congestion is severe, try these tactics for stuffy nose relief. Nasal congestion can also be a symptom of infant GERD. Though experts arenâ€™t sure exactly why the two are linked, stomach acids could reach the back of the nasal cavity in babies with GERD, causing inflammation (and therefore stuffiness) of the sinuses. Prop baby upright.
If possible, try to feed baby upright and prop her up for one to two hours afterward. After feedings, have baby lie at an incline in the crib by elevating the crib mattress with a pillow or two under the mattress (never on top of the mattress, since it can increase SIDS risk). Never use sleep positioners or wedges, even those marketed for babies with GERD, since theyâ€™re also considered a SIDS hazard.
These can include heart disease or being born premature. These babies may not be able to eat much before getting sleepy. Other babies canâ€™t keep a normal amount of formula or breastmilk in their stomachs without vomiting.
Surgery may be an option if medications and lifestyle adjustments donâ€™t help ease your babyâ€™s symptoms and if your baby isnâ€™t gaining weight or has other complications. Tightening the LES makes it more stable so that less acid flows back into the esophagus. The need for this type of surgery is rare, especially in infants.
Others have found that instead of cradling their baby around their body, they can cradle the baby down the body. To do this, some mothers feed twin-style, while others feed standing up; or you can recline so that your baby lies on top of your body.
It is important to note that classic “heartburn” symptoms may resolve, but more subtle evidence of reflux (for example, persisting cough, especially when laying face up [supine]) may develop. Your child’s pediatrician is a valuable asset to help monitor for these less obvious presentations of GERD. Pediatricians diagnosis GERD in infants and children by taking a thorough history supported by a complete physical examination enabling the elimination of other conditions that might cause similar symptoms. While rare, studies may be necessary either to establish/support the diagnosis of GERD or to determine the extent of damage caused by the repeated reflux events. GER and GERD in infants and children are caused by immature neurologic and gastrointestinal systems.
How are GER and GERD in infants and children diagnosed?
Lifestyle changes-including feeding and/or position changes-are recommended as first-line therapy for both GER and GERD. If GERD is severe, treatment may include medication or surgery. The surgery to correct reflux is called fundoplication. Your child’s pediatrician will review your child’s symptoms and feeding patterns and assess your child’s growth by plotting his or her weight and height on a growth chart. This information will help them determine whether your child is a “happy spitter” or has symptoms of GERD.
Some studies have shown that babies benefit when mom restricts her intake of milk and eggs. Formula-fed infants may be helped by a change in formula. Reflux happens when some stomach contents (eg breastmilk) pass from the stomach back up into a babyâ€™s oesophagus (muscular tube that leads from the mouth to the stomach), and sometimes spills out her mouth. This spilling, which can be called spitting up, posseting or bringing milk up, is common in babies, especially after a feed.
The esophagus is the tube that connects the throat to the stomach. Reflux means to flow back or return. Reflux happens because the lower esophageal sphincter in babies opens easily. This allows the acidic stomach juices, food, and fluids to flow back into your childâ€™s esophagus. Reflux is more common among babies who are born prematurely and babies with low birth weight.