Practical advice for new parents

Infant Reflux

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Almost all of us at one time or another have had the uncomfortable burning sensation of heartburn, particularly after eating a spicy or large meal. However, sometimes heartburn can't be attributed to that burrito or overindulgence, and if it occurs too frequently, it might be diagnosed as gastroesophageal reflux disease (GERD).

Unfortunately, it's not just adults who develop GERD. It's also quite common in infants. More and more often, the post-feeding fussiness and spitting up that was once simply accepted as part of a baby's developmental process is now being classified as GERD. Most babies outgrow the disease within the first year of life without any medical intervention, but others may need treatment.

Infant reflux or GERD is caused when the acidic contents of the stomach travels back into the esophagus. In infants, this occurs because the lower esophageal sphincter is not fully developed or strong enough to stop the acid from refluxing. While it's normal for all babies to spit up small amounts after a feeding, those with GERD regurgitate substantial amounts forcefully.

Besides making a baby very uncomfortable, GERD has a number of serious side effects if it is not properly treated. Episodes of choking and esophagitis (irritation of the esophagus) are common. A baby can also develop aspiration pneumonia when the contents of the stomach reflux up to the trachea and into the lungs. As well, babies with GERD are more likely to suffer from lapses in breathing called apnea.

There are common signs to look for to determine if your baby may have GERD including:
  • Fussiness, back arching, or sudden crying after eating.
  • Spitting up or vomiting after most feedings.
  • Fussiness or spitting up that increases when placed in a reclining position.
  • Inability to sleep for more than very short intervals.
  • Frequent hiccups.
  • Poor weight gain.
  • Choking, coughing, or gagging.
  • Constant need to eat or drink followed by spitting up.
  • Hoarse cry.
  • Respiratory problems such as bronchitis, wheezing, or pneumonia.
If you suspect that your baby might be suffering from GERD, schedule an appointment with your doctor. There are several tests to confirm GERD including x-ray and endoscopy. However, most doctors will treat the condition based simply on reviewing the symptoms described by the parents. Treatments include:
  • Switching to soy-based formula.
  • Thickening formula or breast milk with rice cereal.
  • Feeding baby in an upright position and maintaining the position for at least 30 minutes after the feeding.
  • Frequent burping
  • Medication
  • Surgery (Rarely recommended as the other treatments are usually all that's required, except in cases when the baby is failing to grow or has had repeated bouts of pneumonia or apnea).

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