Reviewed by Jennifer Robinson, MD on April 22, 2022 It's common for infants to spit up after a meal. That little spit is called gastroesaphogeal reflux or GER. But frequent
vomiting associated with discomfort and difficulty feeding or weight loss may be caused by something more serious known as GERD (gastroesophageal reflux disease). Both GER and GERD can cause the upward movement of
stomach content, including acid, into the esophagus and sometimes into or out of the mouth. Oftentimes, that
vomiting is repetitive. The differences between the two conditions are marked by the severity and by the lasting effects. Older children also can have GERD. Most of the time, reflux in babies is due to a poorly coordinated gastrointestinal tract. Many infants with GERD are otherwise healthy; however, some infants can have problems affecting their nerves, brain, or muscles. According to the National Digestive Diseases Information Clearinghouse, a child's immature digestive system is usually to blame and most infants grow out of the condition by their first birthday. In older children, the causes of GERD are often the same as those seen in adults. Also, an older child is at increased risk for GERD if they experienced it as a baby. Anything
that causes the muscular valve between the stomach and esophagus (the lower esophageal sphincter, or LES) to relax, or anything that increases the pressure below the LES, can cause GERD. Certain factors also may contribute to GERD, including obesity, overeating, eating spicy or fried foods, drinking
caffeine, carbonation, and specific medications. There also appears to be an inherited component to GERD, as it is more common in some families than in others. The most
common symptoms of gastroesophageal reflux in infants and children are: Many other symptoms are sometimes blamed on GERD, but much of the time, we really aren't sure whether reflux actually causes them. Other problems seen in young children and infants that may be blamed on the condition include: Yes. Most babies outgrow reflux by age 1, with less than 5% continuing to have symptoms as toddlers. However, GERD can also occur in older children. In either case, the problem is usually manageable. Usually, the medical history as told by the parent is enough for the doctor to diagnose GERD, especially if the problem occurs regularly and causes discomfort. The growth chart and diet history are also helpful, but occasionally, further tests are recommended. They may include: There are a variety of lifestyle measures you can try for
acid reflux in babies and older children: For babies: For older children:
If the reflux is severe or doesn't get better, your doctor may recommend medication. Drugs to decrease stomach acid include: Researchers aren't sure whether decreasing stomach acid lessens reflux in
infants. For the most part, drugs that decrease intestinal gas or neutralize stomach acid (antacids) are very safe. At high doses, antacids can cause some side effects, such as diarrhea. Chronic use of very high doses of Maalox or Mylanta may be associated with an increased risk of
rickets (thinning of the bones). Side effects from medications that inhibit the production of stomach acid are uncommon. A small number of children may develop some sleepiness when they take nizatadine, Pepcid, or Tagamet. Surgery for GERD in Babies and KidsSurgery isn't often needed to treat acid reflux in babies and kids. When it is necessary, a fundoplication is the most often performed surgery. During this procedure, the top part of the stomach is wrapped around the esophagus forming a cuff that contracts and closes off the esophagus whenever the stomach contracts -- preventing reflux. The procedure is usually effective, but it is not without risk. Discuss the potential risks and benefits of any operation with your child's doctor. Which is the most appropriate intervention for a 3 month old infant who has gastroesophageal reflux?Doctors may recommend medicines—typically proton pump inhibitors (PPIs) or H2 blockers—if an infant has esophagitis or has bothersome GERD symptoms that don't improve after lifestyle changes. Don't give infants medicines unless told to do so by a doctor. PPIs and H2 blockers lower the amount of acid the stomach makes.
How do you treat reflux in a 3 month old?Feeding changes may help your baby's reflux and GERD:. Add rice cereal to your baby's bottle of formula or breastmilk. ... . Burp your baby after every 1 to 2 ounces of formula. ... . Avoid overfeeding; give your baby the amount of formula or breast milk recommended.. Hold your baby upright for 30 minutes after feedings.. What is best for reflux in babies?Burp them more often
Whether you bottle-feed or breastfeed, make sure to frequently burp your baby. Burping your infant during a feeding may help with reflux symptoms. Burp bottle-fed infants after every 1 to 2 ounces (or more frequently if they eat less). Burp breastfed babies any time they pull off the nipple.
How do doctors treat GERD in infants?If your baby is diagnosed with GERD, your pediatrician may recommend antacids, H2 blockers, or PPIs. Although effective, they come with a risk of side effects that you and your pediatrician should consider. Surgery may be considered when GERD symptoms cause complications.
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