Infant reflux : Causes-Symptoms-Diagnosis-Treatment
What is Infant Reflux ?
Babies who spit up often have reflux. This is normal for healthy infants. As long as your baby is eating well and growing normally, reflux is not a cause for concern.
Reflux (gastroesophageal) is a condition that is not usually serious and becomes less common as a baby gets older. Infants who experience reflux rarely continue to have the problem after they reach 18 months old.
If your infant suffers from reflux, it is not always accompanied by worrisome symptoms such as a poor appetite or weight loss. This can indicate a medical issue such as an allergy, obstruction in the digestive system, or GERD.
Medical terms
Infant reflux, also known as gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) in more severe cases, is a common condition in babies where the contents of the stomach flow back into the esophagus. This happens because the ring of muscle at the bottom of the esophagus, called the lower esophageal sphincter (LES), is not fully developed in infants, making it easier for stomach contents to move upward.
Infant reflux can manifest in several ways:
Spitting up: Most babies with reflux will spit up small amounts of milk or formula after feeding. This is often considered normal and typically decreases as the baby grows.
Vomiting: In some cases, babies may vomit forcefully after feeding. This can be more concerning, especially if it's frequent and associated with poor weight gain or other symptoms.
Fussiness and discomfort: Reflux can cause discomfort, and babies with GER may be fussy, arch their backs, or appear irritable during or after feeds.
Difficulty feeding: Some infants with reflux may have difficulty feeding and may refuse to eat or have shorter feeding sessions.
Coughing or wheezing: Stomach acid or milk that has entered the esophagus can lead to coughing or wheezing, mimicking symptoms of respiratory issues.
Poor weight gain: Severe reflux can interfere with a baby's ability to gain weight properly. In such cases, it's important to consult a healthcare provider.
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Symptoms Infant reflux
Generally, infant reflux is not a cause for concern. The stomach contents are unlikely to have enough acid to irritate the throat or esophagus and cause signs and symptoms.
If you are feeling sick, you should go to the doctor.
See your baby's doctor if your baby:
When you gain weight, it isn't good.
Projectile vomiting is a common symptom of gastroenteritis. It happens when the stomach contents shoot out of the person's mouth (usually with force).
Spits up green or yellow fluid
A sick animal will produce blood or something that looks like coffee grounds.
Refuses food
Has blood in his or her stool
If someone has trouble breathing or has a chronic cough, they may need to see a doctor.
Spitting up starts around 6 months or older.
Is unusually irritable after eating
Some of these symptoms may indicate a potentially serious condition, such as GERD (gastroesophageal reflux disease) or a blockage in the digestive system.
Causes Infant reflux
Infants have a weaker lower esophageal sphincter (LES). That allows stomach contents to flow back up. As the LES becomes stronger, it will only open when your baby swallows and will stay tightly closed at other times. Not throwing up. Keeping food in the stomach where it belongs.
Infant reflux is common in babies and often can't be prevented. These factors include: -being born prematurely -having a large birth weight -being female -having a family history of infant reflux
Lying flat most of the time
Drinking a nearly completely liquid diet
Being born prematurely
Infant reflux can be caused by more serious conditions, such as:
GERD.The reflux has a high level of acid that can irritate and damage the lining of the esophagus.
Pyloric stenosis.A valve between the stomach and small intestine is closed, preventing stomach contents from entering the small intestine.
Food intolerance.The most common cause of allergic reactions to cow's milk is a protein found in it.
Eosinophilic esophagitis.An esophageal injury can be caused by a type of white blood cell called an eosinophil.
Sandifer syndrome.This can cause the head to tilt and rotate abnormally, as well as movements that look like seizures. This is a rare side effect of GERD.
Complications Infant reflux
Reflux in infants usually resolves without causing any problems.
If your baby has a more serious condition such as GERD, he or she might grow poorly. Some research indicates that babies who spit up often might become more likely to develop GERD during later childhood.
Diagnosis Infant reflux
Your doctor will start by conducting a physical exam and asking about your baby's symptoms. If your baby is healthy and growing as expected, testing may not be necessary. However, in some cases your doctor might recommend additional testing.
Ultrasound.This imaging test can detect a condition called pyloric stenosis.
Lab tests.Blood and urine tests can help identify or eliminate possible causes of vomiting and poor weight gain.
Esophageal pH monitoring is a way to measure the acidity of the stomach contents.The doctor will insert a thin tube into the baby's nose or mouth and into the baby's esophagus. This tube is connected to a device that monitors acidity. The baby might need to stay in the hospital while this procedure is being done.
X-rays.This equipment can detect abnormalities in the digestive system, such as an obstruction.Your baby may be given a contrast liquid before the test.
Upper endoscopy.An endoscope is a tube with a camera and light that is passed through your baby's mouth and into their stomach, intestines, and first part of the small intestine. Tissue samples may be taken for analysis. Endoscopy is usually done under general anesthesia in babies and children.
Treatment Infant reflux
Sometimes making some adjustments to how the baby is fed will ease reflux until it resolves on its own.
Medications
Some reflux medications are not recommended for children with uncomplicated reflux. However, a short-term trial of an acid-blocking medication may be prescribed for infants 1 month to 1 year old or for children aged 1 year. omeprazole magnesium (Prilosec) is a good choice for this age group. If your baby is older, or if you think they might be ready for solid foods sooner, you may want to try solids.
My second grader asked me what this passage means: Has poor weight gain and more conservative treatments not worked. I rephrased it for him, in plain language a second grader can understand: My second grader asked me what this passage means: I don't know how to answer this question.
Refuses to feed
The evidence suggests that the esophagus is inflamed.
She has asthma that lasts for a long time and acid reflux.
Surgery
Occasionally, the lower esophageal sphincter is surgically tightened to prevent acid from flowing back into the esophagus. This procedure is usually done only when reflux is severe or when it interferes with a baby's breathing.
Lifestyle and home remedies
To minimize reflux:
Feed your baby in an upright position.After feeding your baby, hold them in a sitting position for at least 30 minutes. This will help the food stay in their stomachs and you won't have to jostle or jiggle them.
Try smaller, more-frequent feedings.If you are bottle-feeding or nursing your baby, cut back on how much you are feeding them.
Take time to burp your baby.Burping your baby often will help to keep air from accumulating in their stomach.
Put the baby to sleep on his or her back.Babies who have reflux should be placed on their backs to sleep.
It is usually not a big deal when an infant has reflux. Keep some burp cloths nearby in case the condition worsens.
Preparing for your appointment
If your child is still having reflux after their first birthday or if they are experiencing symptoms such as lack of weight gain and difficulty breathing, you might be referred to a doctor who specializes in treating children's digestive diseases (pediatric gastroenterologist).
What you can do
Write down your baby's symptoms,How often your baby spits up and the amount of liquid that is spit up will be factors in the diagnosis.
Write down key medical information,You should feed your baby on a schedule and make sure to use the right formula. Feedings should last for a certain amount of time, and you can choose a particular brand of formula.
Write down questions to ask your doctor.
Questions to ask your doctor
What are the most likely reasons for my baby's symptoms?
Does my baby need any tests?
What treatments are available?
Do not change how or what you feed your baby unless you have a doctor's approval.
Do not hesitate to ask more questions.
What to expect from your doctor
When you see your doctor, he or she may ask you some questions, including:
When did your baby's symptoms start?
Does your baby vomit after every feeding or only occasionally?
Is your baby content between feedings?
Has your baby recently switched from breastfeeding to bottle-feeding or switching to different infant formulas?
How often do you feed your baby and how much does he eat at each feeding?
Do all the caregivers feed the baby the same way each time?
Do you notice anything that makes your baby's symptoms worse or better?
General summary
Infant reflux is generally considered a normal part of development in most babies and often improves as the baby gets older and their digestive system matures. However, in some cases, reflux can be more severe and may require medical intervention. If your baby is experiencing severe symptoms, has trouble gaining weight, or you are concerned about their well-being, it's important to consult with a pediatrician or healthcare provider. They can provide guidance on managing the condition and may recommend lifestyle changes or medications to help alleviate symptoms if necessary.
