The signs of silent reflux in babies aren’t always obvious. Here’s how to tell if your baby is silently suffering-and how to make her feel better.
This will ease the heartburn caused by reflux. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Reflux is caused by problems with the lower esophageal sphincter often. This is a muscle at the bottom of the esophagus.
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.
See your GP if your baby has any of the symptoms of GORD. The doctor will check your baby’s growth and development, and if necessary they shall refer you to a paediatrician. Further tests may be arranged if your doctor is concerned.
These are called nasoduodenal tubes. Younger formula-fed infants may benefit from a prethickened, proprietary formula (Enfamil-AR; Mead-Johnson Nutritionals Inc, Evansville, IN). For breast-fed infants, from increasing feeding frequency aside, expressed breast milk might be thickened as described. In addition, early introduction of rice cereal feedings (at age 3 mo) may be attempted. Research suggests that formula thickening is superior to positioning in promoting weight gain and reducing clinical symptoms in infants with gastroesophageal reflux.
Visit our Acid Reflux / GERD category page for the latest news on this subject, or sign up to our newsletter to receive the latest updates on Acid Reflux / GERD. More than 60 million Americans are said to have acid reflux regularly, and it causes numerous hospital admissions.
In infants, GER is much more common than GERD. Treatment for GER and GERD in infants and children include mild elevation of the infant for 15-30 minutes following a feeding, serving smaller but more frequent thickening and feedings of formula or pumped breast milk with rice cereal.
When the LES relaxes often or for too long too, stomach acid flows back into the esophagus. This causes vomiting or heartburn. GERD is a more serious and long-lasting form of gastroesophageal reflux (GER).
If baby is very distractible (pulling off the breast to look around) or fussy at the breast, he may swallow air and spit up more often. Some babies spit up more when they are teething, starting to crawl, or starting solid foods. Spitting up, sometimes called physiological or uncomplicated reflux, is common in babies and is usually (but not always) normal. Most young babies sometimes spit up, 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). A pediatric gastroenterologist will review your child’s history, examine your child and review his or her diet growth and history charts.
- Infant GER occurs in over 50% of healthy infants with a peak incidence (65%) at approximately 4 months of age.
- From the lack of strong evidence Aside, this treatment has some significant drawbacks.
- This causes breathing or heartburn problems.
- Reflux can cause pneumonia or wheezing, and it might hurt to swallow.
It’s also common in babies or children with some impairment of their muscles and nerves, such as cerebral palsy, or those with a cow’s milk allergy (Patient, 2018) . Babies get reflux when the ring of muscle between the oesophagus (food pipe) and stomach is not fully developed. Food or milk can leak out and travel back up the food pipe (NHS, 2019) . Other potential causes for reflux can include an intolerance to cow’s milk protein or other allergies (La Leche League 2017) . Gastroesophageal reflux (GER) happens when an infant’s lower esophageal sphincter is not fully developed, and the muscle lets the stomach contents up the esophagus back.
Infants with GERD may be irritable and/or have respiratory symptoms such as chronic recurrent coughing or wheezing and sometimes stridor. Much less commonly, infants have intermittent apnea or episodes of arching the back and turning the head to one side (Sandifer syndrome). Infants may fail to gain weight or appropriately, less often, lose weight.
There is a genetic predisposition favoring the first-born male. Diagnostic evaluation includes abdominal ultrasound or barium swallow (see below). A surgical procedure provides a cure of the condition.
GERD implies a much different condition. Infants and children with GERD often experience distress because of their reflux even if the refluxed stomach contents are not completely ejected from the mouth. Infants and young children may lose so many calories by expulsion that growth is compromised. Some infants or children with GERD may even become averse to feeding due to repeated associations with feeding and pain. Finally, there are a number of short and long term consequences of GERD that are not associated with infants and children with GER.
But in rare cases and if a healthcare professional thinks they may be helpful, an endoscopy, pH monitoring or barium swallow test can be done (NICE, 2015; NHS, 2016) . Using thickened ‘anti-reflux’ formula milk. You can buy these without a prescription but it’s important to talk to a healthcare professional before you do. There is some caution about their use, such as the fact that they are made at a lower temperature than is currently recommended to get rid of harmful bacteria. In a small number of babies, reflux might be associated with a more serious problem, such as gastro-oesophageal reflux disease (GORD).
In the stomach, the food is digested by acid. When this mixing occurs, the band of muscles at the lower end of the esophagus becomes tight, sealing off the food from up coming back. Spitting up is totally normal – but rarely, it can be a sign of acid reflux in babies, or infant GERD.
For many years, pediatricians have wondered if colic might actually be a burning pain caused by acid reflux in babies (when stomach acid squirts back up the wrong way also known as gastroesophageal reflux, or GER). One book even trumpeted it as “the cause of all colic.” But hundreds of millions of dollars spent on baby antacid medicine (and big-pharma ad campaigns) have been wasted.