Treatment for GER & GERD in Infants

3. Irritability

This can cause inflammation (esophagitis) or sores (ulcers) in the esophagus. These ulcers can be painful.

It will also help the healthcare professional decide whether any tests or treatments are needed or whether the problem will get better on its own. To find out if a child has reflux, a doctor will do a physical examination and ask about symptoms.

Gastroesophageal reflux isn’t a simple issue, but remember, this is a normal phase of infancy. It gets better with time! Spitting up occurs in 50% of infants from 0 to 3 months, 67% in 4-month olds, and 5% in 10-12 month old infants. Take encouragement that reflux almost always resolves spontaneously, in nearly all of these infants, without medication. Overfeeding can contribute to reflux.

Most babies should be placed on their backs to sleep, even if they have reflux. Try smaller, more-frequent feedings. Feed your baby slightly less than usual if you’re bottle-feeding, or cut back a little on the amount of nursing time. Thickening formula or expressed breast milk slightly and in gradual increments with rice cereal. Although recognized as a reasonable strategy, thickening adds potentially unnecessary calories to your baby’s diet.

If you are concerned about reflux, and want to try thickened feedings sooner than that, talk to your provider about it first. Studies report that 15 to 40 percent of infants with reflux have a cow’s milk protein intolerance. This intolerance usually improves naturally by around 12 months, but in the mean time, breastfeeding moms can try eliminating milk products from their diet. Moms may need to eliminate soy products, as well. Talk to your healthcare provider before deciding if further foods should be eliminated (mom’s nutrition is very important, too!).

What happened? Fifty percent of babies got better on the medicine…but 50% got better on the placebo, too. Australian doctors examined 24 babies who were so irritable they had to be hospitalized (all under 3 months of age). Each was checked for acid reflux, but only one had it.

Gastroesophogeal reflux (GER) is the upward flow of stomach contents from the stomach into the esophagus (“swallowing tube”). While not required by its definition, these contents may continue from the esophagus into the pharynx (throat) and may be expelled from the mouth, and in infants, through the nostrils. A more forceful expulsion of stomach contents than do infants and children with GER. Peppermint, caffeine, and certain asthma medications can make the lower esophageal sphincter relax and allow stomach contents to reflux back into the esophagus.

  • They’re not suitable if your baby has reflux, but no other symptoms (NICE 2015b, Rosen et al 2018) .
  • This can cause heartburn or breathing problems.
  • This muscle normally stays closed, so the stomach contents don’t flow back into the esophagus.
  • If symptoms reoccur, avoid that food until your pediatrician recommends to reintroduce it into the diet.
  • Keep your baby upright for 30 minutes after each feeding.

Not only is this medicine unnecessary, it may be harmful! Stomach acid is an early line of defense against the bacteria your baby sucks off her fingers and lips and swallows every day. Studies show that antacid drugs allow bad bacteria to grow in the stomach and may raise the risk for pneumonia and gastroenteritis. And one type of antacid even had to be pulled from the market because it was found to cause sudden death. The healthcare professional should talk with you about reflux and how common it is, give you advice and reassure you about it.

Heartburn / GERD Guide

As long as these children grow well and don’t have other issues caused by reflux, they don’t need treatment. Reflux is often caused by problems with the lower esophageal sphincter. This is a muscle at the bottom of the esophagus. Normally, it opens to let food into the stomach and closes to keep food in the stomach.

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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. Most children outgrow their reflux symptoms by the time they are nine to 12 months old, although it sometimes lingers until 18 months. Some experts also recommend that children with reflux have a trial of an elemental formula, such as Nutramigen or Alimentum, for a few weeks. This is in case the reflux is a sign of a milk protein allergy.

There may not be enough kids now taking PPIs that this is making a significant contribution, but this could certainly happen if we continue with our current course.

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