Pediatric Gastroesophageal Reflux Treatment & Management: Approach Considerations, Positioning, Dietary Measures

When your baby is only a few weeks old, his food pipe is short and narrow. The valve at the entrance to his stomach isn’t strong yet, and it sits just above his diaphragm, the muscle that stretches across his abdomen. These are reasons why the valve can open easily (NICE 2015b) .

Eggs is a big potential offender for really young babies. Even Sylvie, when she was six months old, egg yolks were one of the first foods that we introduced. She had a projectile vomiting episode after she ate her first soft-boiled egg yolk, which was pretty horrifying for us. Then we just waited. We said, “Okay, that doesn’t work.” We went on to liver, which she loved.

But occasionally, frequent and persistent spitting up accompanied by other symptoms or poor weight gain can be an indication that your baby has acid reflux, or GERD. Here’s how you can tell the difference between normal spitting up in babies and GERD. Peppermint, caffeine, and certain asthma medications can make the lower esophageal sphincter relax and allow stomach contents to reflux back into the esophagus.

A small number of children may develop some sleepiness when they take Zantac, Pepcid, Axid, or Tagamet. Researchers aren’t sure whether decreasing stomach acid lessens reflux in infants. Most of the time, reflux in babies is due to a poorly coordinated gastrointestinal tract.

GERD in children may cause repeated vomiting, effortless spitting up, coughing, and other respiratory problems, such as wheezing. Inconsolable crying, refusing food, crying for food and then pulling off the bottle or breast only to cry for it again, failure to gain adequate weight, bad breath, and burping are also common.

Medications may also be suggested – some form a barrier on top of the stomach contents to reduce the risk of them flowing backwards, while others damp down acid production in the stomach. Another type of medication speeds up the rate at which feed passes from the stomach into the duodenum and intestines. All these medications take some time to work but can be very helpful for the majority of children. A pediatric gastroenterologist will only use surgery to treat GERD in infants in severe cases.

infants acid reflux medication

This pain might be due to the irritation that occurs when the contents of the stomach come back up into their esophagus. Talk to your pediatrician if you think your baby is not getting enough to eat because she is spitting up so much. A pediatric gastroenterologist can be helpful to evaluate and manage your child with reflux. Zantac is a common first-line treatment for infants with reflux. But if it isn’t working, talk to your pediatrician about trying a PPI like Prevacid.

Mothers who are breastfeeding should try tweaking their diets, like taking out caffeine, chocolate and garlic, which are known to promote acid reflux. Try smaller, more frequent feedings and hold the baby upright during feedings.

Fifty percent of babies got better on the medicine…but 50% got better on the placebo, too. The treatment of reflux depends upon the infant’s symptoms and age.

Then we went back to egg yolks about a month later, and she had no problem then, and still has no problem with them. So sometimes kids are sensitive to foods initially.

The AAP believes it is important for all pediatric health care providers to be able to properly identify and treat children with reflux symptoms, and to distinguish GER from more worrisome disorders to avoid unnecessary costs and treatments. GER in infants is not considered a disease and does not include a “D.” In fact, GER is considered normal. These infants are known as “happy spitters,” because they are not cranky and do not appear to be in a great deal of pain when spitting up. In fact, your baby may feel better after a good spit-up. Other symptoms of GER include mild feeding problems, such as occasional prolonged feeds or interrupted feeds.

infants acid reflux medication

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