Gastroesophageal Reflux in Children

What is reflux? Reflux is when your baby brings up some of his milk. It’s also known as possetting or spitting up.

infants acid reflux medication

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. Rarely, the lower esophageal sphincter is surgically tightened to prevent acid from flowing back into the esophagus. This procedure (fundoplication) is usually done only when reflux is severe enough to prevent growth or to interfere with your baby’s breathing. Upper endoscopy.

Other than providing medication when it’s not needed, misdiagnosing GERD in infants also masks the real cause of the problem. “When the MII-pH comes back negative, we have to do a better job of investigating the root causes of the symptoms we’re seeing,” says Dr. Aghai. “The study suggests that doctors who suspect infants of having GERD should use the MII-pH to confirm the diagnosis before treating with medications or surgery,” says Dr. Aghai. Unfortunately, says Dr. Aghai, the reason the test isn’t done more often is that it can require advanced training and expertise that isn’t available at all institutions. Nasal congestion can also be a symptom of infant GERD.

Infants prescribed proton-pump inhibitors to treat reflux disease broke more bones in the next several years than infants not given the drug. BreastfeedingIt’s important to know whether you will breastfeed or bottle-feed your baby prior to delivery, as the breasts’ ability to produce milk diminishes soon after childbirth without the stimulation of breastfeeding. Breast milk is easily digested by babies and contains infection-fighting antibodies and cholesterol, which promotes brain growth. Formula-fed babies actually need to eat somewhat less often since formula is less readily digested by the baby than human milk.

If a child vomits with their reflux, PPIs will not change that. PPIs suppress acid production in the stomach so that any vomiting will not hurt as much [8].

  • In these cases, your child’s healthcare provider may recommend tube feedings.
  • Essentially, what you need to know is that heartburn is rarely caused by excess stomach acid production.
  • Gastroesophageal refers to the stomach and esophagus.
  • Unfortunately, very few women do breastfeed for that long.
  • Infants with gastroesophogeal reflux reflect the immaturity their nervous system.
  • Feed frequently.

The procedure can be done with laparotomy, thoracotomy, or laparoscopy. Please share your experience of GERD and acid reflux in baby and children. GER and GERD in infants and children are caused by immature neurologic and gastrointestinal systems. In both GER and GERD, the stomach contents area expelled from the stomach into the esophagus through the opened gastroesophogeal junction.

The first are drugs such as ranitidine (Zantac), famotidine (Pepcid), and lansoprazole (Prevacid), which reduce acid in the stomach. However, research suggests acid is not a major factor in infant reflux and use of antacid in infants can lead to increased risk for infection. The second type is called metoclopramide or reglan, which has a black box warning for the risk of causing permanent damage to child’s brain leading to movement disorders. A third option is surgery to tighten the sphincter at the top of the stomach. All of these interventions come with risks for the infant, and are often prescribed on the basis of symptom association alone.

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Infants who required medications during the first few months of life generally “outgrow” their medication during the end of the first year of life. The diagnosis of GER is based upon characteristic historical facts reported by the infant’s parents coupled with an elimination of pathological conditions by a normal physical exam. It is very rare to need laboratory studies to establish or support the diagnosis. Part of the evaluation of an infant who may have GER is to rule out pyloric stenosis.

Gastric reflux is common in infants because the band of muscle, or sphincter, that squeezes the top opening of the stomach shut, does not yet close at full strength, especially in premature babies. As a result, babies often have reflux and spit up after feeding.

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