Reflux is when a baby brings up milk, or is sick, during or shortly after feeding. It’s very common and usually gets better on its own. GERD. The reflux has enough acid to irritate and damage the lining of the esophagus.
effect on infants
Having an infant sleep on her stomach is only considered in very unusual cases in which the risk of death from complications of GERD outweighs the potential increased risk of SIDS. Always place your baby to sleep on her back unless your pediatrician has told you otherwise. Advice on avoiding triggers (certain types of food, changing formulas in infants) that may be causing GERD symptoms or making them worse. If the reflux is causing problems, this could be gastro-oesophageal reflux disease (GORD), which may need treatment.
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. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Acid Reflux in (GER and GERD) in Children and Teens, April 2015.
Keep the nipple of the bottle filled with milk if youâ€™re bottle-feeding. This can keep your baby from swallowing air when eating. Use a nipple that allows your babyâ€™s mouth to make a good seal with the nipple. This test will show if your childâ€™s stomach contents empty into their small intestine the correct way. Delayed gastric emptying can cause reflux.
Esophageal irritation may decrease food intake as infants learn to avoid reflux by eating less. Significant esophageal irritation (esophagitis) may cause mild, chronic blood loss and esophageal stricture. Laryngeal and airway irritation may cause respiratory symptoms. Aspiration may cause recurrent pneumonia.
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. Complications of GERD are due mainly to irritation caused by stomach acid and to caloric deficit caused by the frequent regurgitation of food. BreastfeedingIt’s important to know whether you will breastfeed or bottle-feed your baby prior to delivery, as the breasts’ ability to produce milk diminishes soon after childbirth without the stimulation of breastfeeding.
Reflux is perfectly normal, common in infants, and is rarely serious. Reflux is more common among babies who are born prematurely and babies with low birth weight. Itâ€™s also common in babies or children with some impairment of their muscles and nerves, such as cerebral palsy, or those with a cowâ€™s milk allergy (Patient, 2018) . If the thickening powder does not help or your baby is breastfed, a GP or specialist might recommend medicines that stop your baby’s stomach producing as much acid.
Infantile gastroesophageal reflux may present with frequent regurgitation or vomiting, postprandial irritability, prolonged feeding or feeding refusal, or back arching. Progressively worsening projectile vomiting in the first months of life is concerning for pyloric stenosis and requires immediate imaging and surgical referral. Recurrent nonprojectile vomiting or regurgitation beyond 18 months of age is uncommon and suggests GERD or more concerning pathology.2, 3, 20 Poor weight gain, parent-reported abdominal pain, and coughing or choking during feeding may also suggest GERD and warrant further workup.
- This is called the lower esophageal sphincter.
- A pH probe can also assess the effectiveness of acid-suppression therapy.
- This allows the acidic stomach juices, food, and fluids to flow back into your childâ€™s esophagus.
- A consultation with a pediatric GI specialist (gastroenterologist) may be necessary.
- For babies who want to breastfeed very frequently, try switching sides every few hours instead of at every feed.
Your baby may bring up small amounts of milk (possetting) or occasionally vomit after eating. He may have hiccups and cough and splutter a little (NHS 2016a) . Some babies also get wheezy after a milky burp (Halit et al 2018, Rosen et al 2018, Tidy 2018) .
There are very cases where children whose GERD is so severe that a surgical procedure must be considered to manage symptoms. The procedure, called a Nissen fundoplication, involves wrapping the top part of the stomach around the lower esophagus. The displaced stomach contracts during the digestive process, and thus closes off the lower esophagus and prevents reflux. In extraordinary circumstances, a feeding tube directly into the stomach is necessary to complement the Nissen fundoplication.
A tube is placed in your childâ€™s nose and guided through the esophagus and stomach. This is called a nasogastric tube. These tubes can also be used to bypass the stomach if needed. Tube feedings can be done with or in place of bottle-feeding or breastfeeding. Some babies with reflux have other conditions that make them tired.
My GP has given her both laxative and gaviscon as prescription and I have changed from breastmilk to aptamil anti colic and constipation. My baby is showing some of signs above and I don’t know what else to do, because every feed is a struggle and I can see she is uncomfortable, she has mild vomiting and suffers a lot when passing wind, and on top of that she needs help when she wants to pass stool, with massaging and gently stimulating her back passage.
What causes gastro-oesophageal reflux?
Sometimes babies may have signs of reflux, but will not bring up milk or be sick. This is known as silent reflux. If your baby has a more-serious condition such as GERD, he or she might show signs of poor growth.
Spitting up, sometimes called physiological or uncomplicated reflux, is common in babies and is usually (but not always) normal. Most young babies spit up sometimes, since their digestive systems are immature, making it easier for the stomach contents to flow back up into the esophagus (the tube connecting mouth to stomach). Burping your infant several times during the feeding (after every ounce or two) will help minimize gastric pressure and the reflux it can cause. Waiting to burp your infant until after she has a full stomach can increase the chances of regurgitation.