Recognizing Acid Reflux/GERD in Infants
Some babies also get wheezy after a milky burp (Halit et al 2018, Rosen et al 2018, Tidy 2018) . As your baby grows, the muscles that control the valve will strengthen, his food pipe will get longer and his stomach will get bigger.
Babies and children can also go through quite normal phases where the problem appears to be improving and then re-occurs quite suddenly, sometimes for no apparent reason. There is a high incidence of sleep disturbance among babies and children with reflux, and they may have difficulty falling asleep or staying asleep. Vomiting is only one sign of reflux.
Premature babies are more likely to be affected by GORD (NICE 2015a, Rosen et al 2018) . Babies with life-long medical conditions, such as cystic fibrosis, are also more likely to suffer from GORD (Rosen et al 2018) . What causes reflux? Reflux happens because of your baby’s age and stage of development.
This causes your baby to vomit. Sometimes acid or material can pass into the windpipe (trachea) and cause coughing or infection. Other times, the contents may only go part of the way up the esophagus. This can cause heartburn or breathing problems.
Babies with reflux may be irritable, spit up or refuse to eat. They arch their bodies during or after feedings, or cry when placed on their backs, especially if they just ate. But sometimes the most obvious symptoms donâ€™t show up-this is known as â€œsilent reflux.â€ Regular reflux occurs when food and digestive acid leaks up from the stomach, causing painful irritation in the esophagus. But silent reflux in babies might not spit up at all, swallowing the regurgitated liquid instead.
Learn the symptoms and causes of bloating to feel more healthy. these causes include bloating, gas, colitis, endometriosis, food poisoning, GERD, IBS (irritable bowel syndrome), ovarian cysts, abdominal adhesions, diverticulitis, Crohn’s disease, ulcerative colitis, gallbladder disease, liver disease, and cancers. Recent studies indicate that between 2% to 8 % of children 3 to 17 years of age experience GERD symptoms (detailed later). Infants with GER generally have no symptoms other than the obvious reflux of fluid out the mouth.
What’s to know about acid reflux in infants?
Gastroesophageal reflux happens when food and stomach acid flow from the stomach back into the esophagus. The esophagus is the tube that carries food from the mouth to the stomach. In adults, reflux is often called heartburn or acid reflux. 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.
In the worst cases, acid reflux may lead to GERD or gastroesophogeal reflux disease or worse conditions. Medications that might be prescribed include H2 blockers and proton pump inhibitors (PPIs). These medications ease symptoms of GERD by lowering acid production in the stomach and can help heal the lining of the food pipe.
For infants with regurgitation hours after eating, who may have gastroparesis, a liquid gastric emptying scan, which uses a radiolabeled liquid, is an alternative to an upper GI series. Infants who have effortless spit ups, who are growing normally, and who have no other symptoms (sometimes referred to as “happy spitters”) have gastroesophageal reflux and require no further evaluation. Infants with GERD may be irritable and/or have respiratory symptoms such as chronic recurrent coughing or wheezing and sometimes stridor.
The main type of antireflux surgery is fundoplication. During this procedure, the top of the stomach is wrapped around the distal esophagus to help tighten the lower esophageal sphincter. Fundoplication can be very effective at resolving reflux but has several complications.
Out of 219 babies hospitalized because of severe reflux, 33% had excessive vomiting and 30% were failing to gain weight but few had just excessive crying. Most babies with reflux have no symptoms other than spitting up often. As long as your baby is growing well and has no other reflux symptoms, he or she wonâ€™t need treatment. Call your childâ€™s healthcare provider if your child vomits after every feeding or has new reflux symptoms. Many babies with reflux will outgrow it by the time they are age 1.
Note that rice cereal will not effectively thicken breastmilk due to the amylase (an enzyme that digests carbohydrates) naturally present in the breastmilk. Allow baby to completely finish one breast (by waiting until baby pulls off or goes to sleep) before you offer the other. Donâ€™t interrupt active suckling just to switch sides. Switching sides too soon or too often can cause excessive spitting up (see Too Much Milk?).
Gravity can help stomach contents stay where they belong. Be careful not to jostle or jiggle your baby while the food is settling. Rarely, the lower esophageal sphincter is surgically tightened to prevent acid from flowing back into the esophagus.
Rarely, infant reflux can be a sign of a medical problem, such as an allergy, a blockage in the digestive system or gastroesophageal reflux disease (GERD). Infant reflux occurs when food backs up (refluxes) from a baby’s stomach, causing the baby to spit up. Sometimes called gastroesophageal reflux (GER), the condition is rarely serious and becomes less common as a baby gets older.