Strategies For Dealing With Reflux
While it would be great if there was a quick fix for refluxespecially when your little one appears to be uncomfortablethere really isnt one. Mostly its a matter of time for growth and development. However, there are some specific feeding strategies that can lessen reflux.
Urgent Advice: Ask For An Urgent Gp Appointment Or Call 111 If Your Baby:
- has sick that’s green or yellow, or has blood in it
- has blood in their poo
- has a swollen or tender tummy
- has a very high temperature or they feel hot or shivery
- keeps being sick and cannot keep fluid down
- has diarrhoea that lasts for over a week or has signs of dehydration
- will not stop crying and is very distressed
- is refusing to feed
If a GP thinks something else is making your baby sick, they may send your baby for tests in hospital with a specialist.
Recognizing Acid Reflux/gerd In Infants
Understanding acid reflux
Acid reflux happens when the contents of the stomach back up into the esophagus.
The esophagus is the tube that carries food from the throat to the stomach. At the bottom of the esophagus where it joins the stomach is a ring of muscle that normally opens when you swallow. This ring of muscle is known as the lower esophageal sphincter .
When the LES doesnt close completely, stomach contents and digestive juices can come back up into the esophagus.
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When Should I Use Feed Thickeners And Other Medicines
If you have tried the suggestions above and nothing seems to be working, talk to your lead maternity carer, local well child provider or doctor. They may suggest other strategies. They may also discuss the use of feed thickeners and other medicines to reduce the spilling, particularly if your baby also has significant pain or growth problems.
- Feed thickener is added to baby formula with the idea that it makes the formula heavier and less likely to rise back up the oesophagus.
- Medicine such as Infant Gaviscon works as an antacid and a thickener.
- It can be given to breast-fed infants in place of thickened formula.
- Medicine such as omeprazole may be considered for the small number of babies that have GORD.
What Treatment Does My Child Need For Urinary Reflux
Urinary reflux usually gets better by itself as your child grows, especially if it is mild.
The treatment aims to prevent UTIs while your child is young, when they can cause damage to the kidneys. Sometimes, your doctor may prescribe a small dose of antibiotics to prevent UTIs until the urinary reflux improves or gets better by itself.
In most children, no treatment is necessary and your childs doctor will monitor the growth and health of your childs kidneys with scans. This will depend on how severe your childs reflux is.
Regular urine tests may be necessary to make sure there is no infection present. If your child develops any symptoms of a UTI while on antibiotics, take them to your family doctor for an immediate urine test.
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Complications Of Spitting Up
- Most infants are “happy spitters.” Normal spitting up occurs in half of babies. It does not cause crying or colic.
- Normal crying occurs in all babies. Frequent crying occurs in 15% of babies. Crying and colic are not helped by heartburn meds. These meds also have side effects.
- If they develop complications, it’s called GERD . This occurs in less than 1% of babies.
What Are The Kidneys And What Do They Do
The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults and the amount produced depends on their age. The kidneys work around the clock a person does not control what they do. Ureters are the thin tubes of muscleone on each side of the bladderthat carry urine from each of the kidneys to the bladder. The bladder stores urine until the person finds an appropriate time and place to urinate.
The kidney is not one large filter. Each kidney is made up of about a million filtering units called nephrons. Each nephron filters a small amount of blood. The nephron includes a filter, called a glomerulus, and a tubule. The nephrons work through a two-step process. The glomerulus lets fluid and waste products pass through it however, it prevents blood cells and large molecules, mostly proteins, from passing. The filtered fluid then passes through the tubule, which changes the fluid by sending needed minerals back to the bloodstream and removing wastes. The final product becomes urine.
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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.
Acid Reflux And Gastroesophageal Reflux Disease In Babies: Know The Signs
The most common symptom of acid reflux in adults is pain or a burning sensation in the chest, but because an infant cannot describe this feeling to you, it is important to be on the lookout for other symptoms that are more easily recognizable.
Often, children who are under the age of 12 years old will have different symptoms than the classic symptoms of reflux in adults, and these symptoms might not include the telltale signs that you are familiar with.
The ten most common symptoms of acid reflux in children include:
Aside from these main signs, acid reflux may also be a symptom associated with frequent ear infections or colds, bad breath, loss or decay of tooth enamel, or a rattling in the chest.
Acid reflux is very common in children who are still in their first year of life, and many babies outgrow it. However, children with Down Syndrome or certain neuromuscular disorder may be at an increased risk of experiencing acid reflux.
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Vesicoureteral Reflux Is A Serious Condition
It is important to know that your child may outgrow VUR. The average age when a child may outgrow VUR is five or six years old. Children are more likely to outgrow VUR with lower grades of Reflux. This is what your doctor or pediatric urologist calls spontaneous resolution. If your child has been diagnosed with VUR it is really important that VUR be treated to avoid long-term complications.
The likelihood of spontaneous resolution varies according to a childs age, grade of VUR, and whether the VUR is on one ureter or both.
VUR Resolution Chart Percent Chance of Reflux Resolution After A Specified Number of Years1.
American Urological Association
More severe grades of reflux are associated with lower rates of spontaneous resolution and a higher incidence of renal scarring.2
Continual UTIs can permanently damage the kidney
When a child has VUR, urine backs up into the kidney. Sometimes the urine contains bacteria that cause a urinary tract infection . Bacteria in the kidney can lead to damage over time, which may eventually lead to kidney failure and/or high blood pressure. Some kidney infections that develop suddenly can even be life threatening. The risk of kidney damage is greatest during the first 6 years of life. The goal is to find VUR early and prevent infection that could result in kidney damage.
Antibiotics are not an effective treatment for preventing kidney disease3
What Treatments Might The Doctor Give For My Infant’s Gerd
If feeding changes do not help enough, the doctor may recommend medicines to treat GERD. The medicines work by lowering the amount of acid in your baby’s stomach. The doctor will only suggest medicine if your baby still has regular GERD symptoms and:
- You already tried some feeding changes
- Your baby has problems sleeping or feeding
- Your baby does not grow properly
The doctor will often prescribe a medicine on a trial basis and will explain any possible complications. You shouldn’t give your baby any medicines unless the doctor tells you to.
Medicines for GERD in babies include:
- H2 blockers, which decrease acid production
- Proton pump inhibitors , which lower the amount of acid the stomach makes
If these don’t help and your baby still has severe symptoms, then surgery might be an option. Pediatric gastroenterologists only use surgery to treat GERD in babies in rare cases. They may suggest surgery when babies have severe breathing problems or have a physical problem that causes GERD symptoms.
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What Causes Gerd In Babies And Children
Most of the time, reflux in babies is due to a poorly coordinated gastrointestinal tract. Many infants with GERD are otherwise healthy however, some infants can have problems affecting their nerves, brain, or muscles. According to the National Digestive Diseases Information Clearinghouse, a child’s immature digestive system is usually to blame and most infants grow out of the condition by their first birthday.
In older children, the causes of GERD are often the same as those seen in adults. Also, an older child is at increased risk for GERD if they experienced it as a baby. Anything that causes the muscular valve between the stomach and esophagus to relax, or anything that increases the pressure below the LES, can cause GERD.
Certain factors also may contribute to GERD, including obesity, overeating, eating spicy or fried foods, drinking caffeine, carbonation, and specific medications. There also appears to be an inherited component to GERD, as it is more common in some families than in others.
Gerd Vs Regular Reflux
While there are many strategies you can try to lessen reflux in babies, you may need to take a different approach if your baby is dealing with GERD, or gastroesophageal reflux disease. The symptoms are more severe and may include:
- Abdominal pain
- Crying or arching back during feeding
- Refusing to eat
- Having blood or greenish color in spit-up
- Increased frequency or intensity of spit-up
- Swollen or distended belly
- Wheezing and/or coughing
If these symptoms sound familiar, call your pediatrician so you can both decide the best course of treatment for your baby. In some cases, medication is prescribed.
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What Is Reflux In Babies
May 09, 2021
Reflux in newborn babies is very common after you feed them, its not unusual for a bit of milk to come back up , and its a totally normal process where your baby just brings up a little bit of what they swallowed down their food pipe . Acid reflux is a more uncomfortable and more serious form of this, which can lead to vomiting and weight loss. Symptoms include:
- Vomiting regularly, especially after feeding
- A persistent cough or wheezing
- Refusal to eat or difficulty eating
- Heartburn, gas, abdominal pain, or colicky behaviour
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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What Are The Symptoms Of A Urinary Tract Infection
Urinary tract infections often result from VUR. If your child has symptoms of a UTI, they may also have VUR. Symptoms of a UTI include:
- Burning or pain when urinating.
- Pain in the lower abdomen.
- Pain in the lower or upper back.
- The need to urinate more often.
- Only a few drops come out when trying to urinate.
- Bladder leakage.
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Potential Risks Of Gord Medications
Taking medications for GORD means that babies may be at risk of the following compared to babies who do not take these medications:
- 3 to 6 times more likely to develop gastroenteritis and pneumonia.
- 4 times more likely to not get enough nutrients from their food.
- Almost 2 times more likely to have a bone fracture later in life.
- 2 times more likely to get an infection that causes severe diarrhoea .
- 1.5 times more likely to develop asthma as a child.
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