What Is Infant Reflux
When your baby is spitting up, it simply means that whats in your babys stomach is coming back up through their mouth or nose. The official name is gastroesophageal reflux which is usually shortened to just reflux.
Reflux alone is a normal thing for babies, and for most it doesnt become a bigger issue.
What Are The Symptoms Of Gerd In Infants And Children
The most common symptoms of gastroesophageal reflux in infants and children are:
- Frequent or recurrent vomiting
- Frequent or persistent cough or wheezing
- Refusing to eat or difficulty eating
- Heartburn, gas, abdominal pain, or colicky behavior associated with feeding or immediately after
- Regurgitation and re-swallowing
- Complaining of a sour taste in their mouth, especially in the morning
Many other symptoms are sometimes blamed on GERD, but much of the time, we really aren’t sure whether reflux actually causes them. Other problems seen in young children and infants that may be blamed on the condition include:
- Proton-pump inhibitors such as esomeprazole , lansoprazole , omeprazole , omeprazole-Sodium Bicarbonate , pantoprazole , rabeprazole
Researchers aren’t sure whether decreasing stomach acid lessens reflux in infants.
For the most part, drugs that decrease intestinal gas or neutralize stomach acid are very safe. At high doses, antacids can cause some side effects, such as diarrhea. Chronic use of very high doses of Maalox or Mylanta may be associated with an increased risk of rickets .
Side effects from medications that inhibit the production of stomach acid are uncommon. A small number of children may develop some sleepiness when they take nizatadine, Pepcid, or Tagamet.
How To Treat Silent Reflux
If treatment is needed, your childs pediatrician may recommend GERD medications, such as H2 blockers or proton pump inhibitors, to help reduce the amount of acid made by the stomach.
The AAP also recommends the use of prokinetic agents.
Prokinetic agents are drugs that help increase movement of the small intestine so stomach contents can empty faster. This prevents food from sitting too long in the stomach.
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Care Advice For Spitting Up
Surgery For Gerd In Babies And Kids
Surgery isn’t often needed to treat acid reflux in babies and kids. When it is necessary, a fundoplication is the most often performed surgery. During this procedure, the top part of the stomach is wrapped around the esophagus forming a cuff that contracts and closes off the esophagus whenever the stomach contracts — preventing reflux.
The procedure is usually effective, but it is not without risk. Discuss the potential risks and benefits of any operation with your child’s doctor.
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Formula Feeding And Reflux
If your baby is on infant formula, speak to your public health nurse to make sure that they are taking the correct amount of formula for their age.
To help their symptoms, try:
- offering smaller but more frequent feeds instead of a large volume in one go
- feeding in a more upright position
- winding regularly during a feed
- holding your baby upright for a while after feeding.
Avoid chopping and changing your babys infant formula. If you are considering changing your babys infant formula milk, discuss it with your public health nurse first.
When To Call Your Doctor
Reflux isnât usually a problem as long your baby seems generally happy and well, and his or her weight gain and growth are on track.
In some cases, the reflux may be caused by an underlying condition that needs to be diagnosed and treated. See your doctor if you notice any of these symptoms:
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Reflux that starts when your baby is 6 months old or later
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Reflux that doesnât clear up by the age of 12 months
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A lot more crying or distress than usual
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Weight loss or no weight gain
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Reflux that often ends in projectile vomiting
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Yellow or green vomit
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A swollen, hard or tender stomach
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If your baby arches his or her back during or after a feed.
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What Is Reflux In Babies
So we know that reflux is common, but what causes reflux in babies? Because infants dont yet have a fully developed lower esophageal sphincter the muscle at the bottom of the esophagus that opens and closes to allow food into the stomach and keep it there food can easily slip back up the esophagus.
Acid reflux, also known as gastroesophageal reflux , is normal reflux that occurs among infants. 40-65% of infants experience this normal reflux. How do you know if a baby has acid reflux? If an infant is spitting up milk after feedings, theres a good chance that he or she has this type of reflux. As babies mature, GER usually goes away on its own with no intervention needed.
If a baby experiences complications that go beyond just spitting up small amounts milk such as difficulty feeding and discomfort he or she may have GERD. The symptoms of GERD include the following: 1
- Arched back during or after eating
- Crying more than three hours per day with no medical cause
- Coughing
- Poor eating or refusing to eat
- Poor weight gain or weight loss
- Trouble breathing
- Forceful or frequent vomiting
GERD usually occurs when the LES muscle becomes weak or relaxes when it shouldnt, resulting in stomach contents resurfacing into the esophagus.
How Long Does It Take For Silent Reflux To Resolve
Most children will outgrow silent reflux they turn one.
Many children, especially those who are promptly treated with at-home or medical interventions, have no lasting effects. But if delicate throat and nasal tissue is frequently exposed to stomach acid, it can cause some long-term problems.
Long-term complications for persistent, unmanaged reflux
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Studies On Baby Acid Reflux
Australian doctors examined 24 babies who were so irritable they had to be hospitalized . Each was checked for acid reflux, but only one had it. In fact, studies now show that even babies who do have severe reflux usually have no pain. 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.
A University of Pittsburgh study confirmed that acid reflux medicine makes no difference for most babies with colic. Doctors caring for 162 infants with marked crying after eating gave half the babies a powerful antacid the rest got a placebo. What happened? Fifty percent of babies got better on the medicinebut 50% got better on the placebo, too.
In truth, all babies have reflux we just call it by a different name: spitting up. There is a muscle at the bottom of the esophagus that keeps stomach juice from flowing back up to the mouth. For the first 6 months it is pretty weak, so babies often burp up a smidge of their last mealmixed with a bit of stomach acid. And, some barf huge amounts, with no crying at all. Doctors call them happy spitters and suggest just burping them better and not overfeeding. For these families, the biggest problems caused by acid reflux in infants are milk stains on clothes and sofas.
Tips To Help Your Baby With Reflux
You can help your child if they have reflux.
During feeding:
- hold your baby upright for a short time after they feed
- try not to handle your baby too much
- where possible, it may be helpful to change baby before or during a feed, rather than afterwards when their stomach is full.
If your baby brings up a lot of milk, they may be hungry again and you might need to feed them again sooner than usual.
For most babies, you don’t have to do anything about reflux. It is a natural process which will get better by itself. Changing formulas won’t help and neither will a change from breastfeeding to bottles.
There are thickened formulas for babies who are formula fed with reflux, although there is not a lot of research to support how effective these are. There are also many over-the-counter products aimed at reducing wind, colic and reflux, but there is no scientific evidence that shows these preparations work. If you choose to use such a preparation, make sure you choose one that has no alcohol or sugar.
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And What Causes Reflux
You may wonder why some babies get reflux and others do not well its because of muscle development. The muscles at the bottom of the oesophagus are not fully developed and they allow the milk to leak out or travel back up the pipe. Some babies do suffer from reflux because of a reaction to cow’s milk, so consider removing it from their diet if this is the case.
A Guide To Reflux In Babies
If you have a baby, then youre probably already well aware of the fact that all babies spit up . For most babies, this is completely normal and is not a cause for alarm. But for some, its a little more complicated than that. Find out if your baby is just a happy spitter or if it could be something more.
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Does My Baby Have Silent Reflux
Reflux disease is seen in about children. While gastroesophageal reflux disease and LPR can exist together, symptoms of silent reflux are different from other types of reflux.
In babies and young children, typical signs include:
- breathing problems, such as wheezing, noisy breathing, or pauses in breathing
- gagging
- chronic respiratory conditions and ear infections
- difficulty breathing
- difficulty feeding
- spitting up
- failure to thrive, which may be diagnosed by a doctor if your baby isnt growing and gaining weight at the expected rate for their age
Babies with silent reflux may not spit up, which can make it difficult to identify the cause of their distress.
Older children may describe something that feels like a lump in their throat and complain of a bitter taste in their mouth.
You may also notice hoarseness in your childs voice.
What Is Silent Reflux In Babies
If your baby is showing the symptoms of reflux, without spitting out milk, then they could have silent reflux instead of the milk flowing back up to the oesophagus and being spat out, its swallowed by your baby7.
Silent reflux can be confusing, hard to identify and incredibly frustrating. This is because whilst you might not be able to physically see whats being brought back up, the baby reflux symptoms are very much at play.
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What Causes Reflux And How To Recognize It
Nature has provided its own means of preventing acid and other stomach contents from flowing back up into our throats and mouths. A valve called the lower esophageal sphincter opens during normal digestion to allow food to pass into the stomach but closes after eating to prevent the stomachs contents from escaping back up the wrong way. If for some reason the LES has a weak action or does not function at the right time, then food and stomach acid can be regurgitated back into the esophagus as earlier described. A baby spends most of the time in a horizontal position, the liquid contents of babys diet are more likely to flow back into the esophagus. If this happens a lot then your child may be suffering from GER.
The symptoms to watch out for are: frequent and recurrent vomiting, persistent coughing at meal times, and signs of heartburn, gas or abdominal spasms. As the child moves into its second year, additional symptoms may include slowed growth rate, persistent refusal of food and a hoarse scratchy voice. Chances are the problem will resolve itself in time. But it never does any harm to consult your pediatrician who is able to perform a whole batch of diagnostic tests where deemed necessary.
It is also important to bear in mind that infants suffer from a different form of acid reflux to that occurring in children and adults where therapy may be complicated for a wide spectrum of reasons and where the patients physical condition and life style can play a decisive role.
How Do Doctors Diagnose Reflux And Gerd In Infants
In most cases, a doctor diagnoses reflux by reviewing your baby’s symptoms and medical history. If the symptoms do not get better with feeding changes and anti-reflux medicines, your baby may need testing.
Several tests can help a doctor diagnose GERD. Sometimes doctors order more than one test to get a diagnosis. Common tests include:
- Upper GI series, which looks at the shape of your baby’s upper GI tract. Your baby will drink or eat a contrast liquid called barium. The barium is mixed in with a bottle or other food. The health care professional will take several x-rays of your baby to track the barium as it goes through the esophagus and stomach.
- Esophageal pH and impedance monitoring, which measures the amount of acid or liquid in your baby’s esophagus. A doctor or nurse places a thin flexible tube through your baby’s nose into the stomach. The end of the tube in the esophagus measures when and how much acid comes up into the esophagus. The other end of the tube attaches to a monitor that records the measurements. Your baby will wear this for 24 hours, most likely in the hospital.
- Upper gastrointestinal endoscopy and biopsy, which uses an endoscope, a long, flexible tube with a light and camera at the end of it. The doctor runs the endoscope down your baby’s esophagus, stomach, and first part of the small intestine. While looking at the pictures from the endoscope, the doctor may also take tissue samples .
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