Reflux and GERD in Babies

GERD or gastroesophageal reflux disease is a condition that primarily affects a muscle called the lower oesophageal sphincter or the LES. This muscle is located in the lower oesophagus close to the stomach. The condition can afflict both adults and babies.

What Is Reflux And GERD In Babies?

GERD in adults can be the cause of gas, heart burn, and acidic indigestion. In babies, GERD can lead to drooling more than usual, spitting up, vomiting and irritability. This can lead to breathing problems and tummy aches too. GERD can also lead to acid reflux in infants.

It is believed that infant gastroesophageal reflux is as harmless as its adult variant. GERD or reflux is not considered a serious condition and does not impair growth or capabilities of the child.

How Common Are GERD And Reflux?

It is common for babies to spit up or vomit after a meal ever so often. However, if it becomes frequent, there is a strong likelihood of GERD. Many a time, a poorly coordinated gastrointestinal tract is responsible for GERD. Babies have a developing digestion track, and naturally, have a weak LES which leads to spitting up or vomiting on occasion. This can very easily escalate into GERD.

Studies by the National Digestive Disease Clearinghouse indicate that most children grow out of GERD by their first birthday. They hypothesize that the child’s immature digestive system might be the reason for most baby reflux tendencies.

What Causes Acid Reflux And GERD In Infants?

In most cases, GERD is caused due to the LES not functioning properly or not having developed sufficiently. In some cases, it can be due to the diet of a mother, especially around the breastfeeding stages. There are multiple other causes for GERD in slightly older children:

• Medication
• Sodas
• Excess dairy consumption
• A side effect of lactose intolerance
• Obesity
• Spicy food
• Overeating

An important point to keep in mind is that a child is more susceptible to GERD if they had it at a younger age.

Signs And Symptoms

Symptoms of GERD are extremely hard to identify because it is challenging to differentiate between the normal occurrence of a baby vomiting after feeding formula and GERD. If the symptoms are so similar then how do you know if your baby has acid reflux or GERD?

To get a proper diagnosis, it is best to consult your doctor. There are other signs you can look out for in the meanwhile, like:

• Forceful spitting up and vomiting – It is normal for babies to spit up or vomit a little bit during the initial stages of breastfeeding or bottle feeding. However, if the child either spits up or vomits and immediately begins crying in pain, it could be a sign of GERD.
• Difficulty in eating – If the baby has trouble eating or refuses to swallow when being fed, it could be due to the contents of the meal coming back up the oesophagus. This is a sign of mild GERD.
• Fussing while being fed – If the baby cries constantly while being fed, it could be a sign of the irritation caused in the LES that results in GERD.
• Disturbed sleep – An irregular sleep cycle or disturbed sleep can be due to irritation of the stomach caused by acid reflux. This could be a sign of GERD.

To better understand all the symptoms of GERD, visit your local healthcare specialist.

How Are GERD And Reflux Diagnosed?

In most cases, doctors diagnose GERD through symptomatic history. It also helps to know the diet history and growth chart for the child. There are, however, further tests that can help with the diagnosis of GERD:

• Barium Swallow: This is a type of X-ray that helps identify a narrowing in the oesophagus, the upper part of the small intestine, and the stomach.
• pH Probe: This test is done by sending a long thin tube that holds a probe into the oesophagus to measure stomach acids for 24 hours. The probe is passed through the nose. This test can help identify GERD. It can also check if any breathing problems the child may have are a result of GERD.
• GI Endoscopy: This test involves the insertion of a long thin tube down your child’s throat. This tube (called an endoscope) has a camera attached to it. Testing GERD using this also helps doctors investigate other possibilities like obstructions in the gastrointestinal tract or stomach.

Your doctor will recommend the above tests if he deems they are necessary to diagnose GERD and reflux in your child.

Risk Factors For Baby GERD

Your baby may be at risk for GERD due to numerous pre-existing conditions and external reasons:

• Lactose Intolerance – Consumption of dairy when your baby is lactose intolerant can increase the risk of an episode of acid reflux.
• Spicy Food – If the nursing mother consumes food that is spicy, there are chances a breastfeeding baby can have an episode of acid reflux.
• Narrow oesophagus – A baby born with a naturally narrow oesophagus may be at risk for GERD.
• Oesophagitis – This is a condition where the oesophagus becomes inflamed, and this can cause acid reflux in children.

Severe allergic reactions and infections are known to aggravate GERD and can also be a cause for it. If your baby has a weak gastrointestinal tract, they may have episodes of GERD.

Treatment For Acid Reflux In Babies

Depending on the severity of the GERD, the treatment varies.

Medication

The most common types of GERD can be treated with medication. Mild GERD is usually treated by administration of oral medication. This can be both preventive and SOS based. The preventive GERD is usually a course of medication that is taken 30 minutes before breakfast, and in slightly more severe cases, 30 mins before dinner. You can use anti-acids to treat heavy belching that maybe a sign of GERD. In cases of more severe GERD, doctors may inject medication as the time the medicine takes to act is much quicker. This is usually given in smaller doses for infants. Consult your physician before administering acid reflux medicine for babies.

Drugs to control reflux

There are numerous drugs (like pantoprazole) that can be used to help control reflux. These medicines are largely sold over the counter. Talk to your physician before administering any drug to your child.

Surgery

In extremely severe cases, some people may need surgery for GERD. This is extremely rare for infants.

In severe cases, where the infant suffers from breathing issues or has stunted growth due to acid reflux, your paediatrician will suggest a surgery called fundoplication. In this surgery, the surgeon will tighten the LES so that less stomach acids will flow back into the oesophagus. This surgery is extremely rare and is tried only if all other options with medications do not work.

Do Infants Outgrow GERD?

More than 95% of all babies outgrow GERD by the time they are one-year old. Very few toddlers will continue to display symptoms of the condition. However, it can occur in older children too.

How Long Does Baby GERD Last?

Most babies outgrow GERD in their first year. In the next couple of years, you should see all signs and symptoms of GERD disappearing entirely.

Complications GERD

GERD could result in the following:

• Projectile vomiting of a fluid that is green/yellow/brown in colour
• Crying for more than three hours a day and excessive irritability
• Problems with breathing, especially after vomiting
• Difficulty in gaining weight or loss of appetite
• Greater risk of cough, sinus, ear infections or even pneumonia
• Damage to tooth enamel due to the stomach acid

Feeding Advice For Reflux In Babies

While feeding, you can try a few steps that could greatly improve your baby’s unease.

• Try feeding your baby upright
• Give them small feeds, but more frequently
• Burp them often to help with the digestion
• Lay your baby on their left side for more comfort

Home Remedies & Lifestyle Changes To Neutralize Baby Acid Reflux

• Sleeping adjustments: Raise your baby’s bassinet by 30 degrees to ensure that their head is elevated. In this position, gravity will ensure that the stomach acids do not flow back up the oesophagus.
• Massage therapy: Rub your baby’s stomach with some natural oils in a clockwise motion. This will stimulate the vagus nerve which also controls the respiratory and digestive systems.
• Apple cider vinegar: This is a great cure for reflux in babies. It works by balancing the pH of the stomach. Mix a quarter teaspoon of apple cider vinegar in a cup of water. Feed your baby a few spoons of the liquid at frequent intervals.
• Coconut oil: The anti-inflammatory nature of coconut oil is great for soothing the stomach of your baby. You can rub coconut oil on your baby’s abdomen a few times each day.
• Chamomile: Its antispasmodic properties are helpful with any digestive issues. Put half a spoon of chamomile flowers in a cup of hot water. Let the flowers steep for up to ten minutes. Strain and allow it to cool. Feed your baby a couple of teaspoons in frequent doses through the day.

GERD can be a very uncomfortable condition for your baby. Talk to your healthcare professional about the different options available to alleviate the stress on your baby.