The prognosis with surgery is considered excellent. The surgical morbidity and mortality is higher in patients who have complex medical problems in addition to gastroesophageal reflux. Indeed, most cases of gastroesophageal reflux in infants and very young children are benign, and 80% resolve by age 18 months (55% resolve by age 10 mo), although some patients require a “step-up” to acid-reducing medications.
Factors that increase this gradient or decrease the pressure in the LES predispose to reflux. The pressure gradient may increase in infants who are overfed (excessive food causes a higher gastric pressure) and in infants who have chronic lung disease (lower intrathoracic pressure increases the gradient across the LES) and by positioning (eg, sitting increases gastric pressure). Tube feedings.
Burp baby frequently, and avoid bouncing baby right after feedings to help alleviate symptoms of GERD. Try offering a pacifier when you’re done feeding, since sucking can soothe infant reflux. Spitting up is totally normal – but rarely, it can be a sign of acid reflux in babies, or infant GERD.
The stomach contents flow back into the oesophagus and can cause vomiting. There are several reasons a baby may vomit and a doctor will need to rule out other causes, but one possible diagnosis is GERD (gastroesophageal reflux disease), also referred to as GOR (gastro-oesophageal reflux). As babies digest their food, the lower esophageal sphincter may open. This lets stomach contents go back up into your child’s esophagus. Sometimes the contents go all the way up.
Medications are not recommended for children with uncomplicated reflux. Reflux medications can have complications, such as preventing absorption of iron and calcium in infants and increasing the likelihood of developing particular respiratory and intestinal infections. Keeping infants upright for at least 30 minutes following feeds and elevating crib and diaper-changing tables by 30 degrees may also help prevent symptoms of reflux.
The amount of spitup typically appears to be much more than it really is. 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.
Over time, babies with reflux may not gain weight as expected (failure to thrive) and may have frequent chest infections due to aspirating (breathing in) stomach contents into the windpipe and lungs. The inside surface of the oesophagus may become inflamed due to contact with stomach acid, which may lead to scarring and narrowing. Your GP will only prescribe these if your baby has a sore food-pipe from the amount of stomach acid he’s bringing up. They’re not suitable if your baby has reflux, but no other symptoms (NICE 2015b, Rosen et al 2018) . You could ask your GP about giving your baby an infant antacid.
This sequence occurs in all people, but it happens more frequently in infants under the age of 1 year. There is a muscle at the lower end of the food pipe called the lower esophageal sphincter. This muscle relaxes to let food into the stomach and contracts to stop food and acid passing back up into the food pipe. Your baby does not usually need to see a doctor if they have reflux, as long as they’re happy, healthy and gaining weight.
- In many cases, diet and lifestyle changes can help to ease GERD.
- This means too few red blood cells in the bloodstream.
- A consultation with a pediatric GI specialist (gastroenterologist) may be necessary.
- National Institutes of Health, National Library of Medicine, ENT Manifestations of Gastro-oesophageal Reflux in Children, October 2006.
To help you sort it all out, the American Academy of Pediatrics (AAP) answers common questions about typical digestive functioning and explains the differences between gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD). Weight issues may not necessarily reflect the severity of a child’s reflux. Babies and children can have normal weight and weight gains even with significant reflux. If a child has severe gastro-oesophageal reflux which is not controlled with medication or is causing significant complications, your doctor may recommend an operation called a fundoplication to prevent reflux.
To do this, some mothers feed twin-style, while others feed standing up; or you can recline so that your baby lies on top of your body. After a feed, keep baby upright and still.
How are GER and GERD in infants and children diagnosed?
Gastroesophageal reflux disease (GERD) is a digestive condition in which the stomach’s contents often come back up into the food pipe. Dietary changes can help to ease symptoms. For example, high-fat and salty foods can make GERD worse, while eggs and some fruits can improve it.
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 feedings and thickening of formula or pumped breast milk with rice cereal. In older children, it is worthwhile to maintain a dietary journal to help identify GERD and food relationships. Carbonated or caffeinated beverages may be associated with GERD. In some cases, medications may be indicated.
Your infant may refuse to eat if they experience pain during feeding. This pain might be due to the irritation that occurs when the contents of the stomach come back up into their esophagus. Acid reflux happens when the contents of the stomach back up into the esophagus.
Please share your experience of GERD and acid reflux in baby and children. Children who experience GERD symptoms also have a favorable prognosis though it may require longer use of medications and utilization of life style changes for many months. It is important to note that classic “heartburn” symptoms may resolve, but more subtle evidence of reflux (for example, persisting cough, especially when laying face up [supine]) may develop. Your child’s pediatrician is a valuable asset to help monitor for these less obvious presentations of GERD.