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Acid reflux in infants: Causes, symptoms, and treatment

Children younger than age 12 will often have different GERD symptoms. They will have a dry cough, asthma symptoms, or trouble swallowing.

These babies have been termed by some as ‘Scrawny Screamers’ (as compared to the Happy Spitters). There seems to be a family tendency toward reflux. GERD is particularly common in preemies (due to their immaturity) and in babies with other health problems. GERD usually improves by 12-24 months. Premature babies are more likely to be affected by GORD (NICE 2015a, Rosen et al 2018) .

If feeding and positional changes do not improve GERD, and the infant still has problems with feeding, sleeping, and growth, a doctor may recommend medications to decrease the amount of acid in the infant’s stomach. If an infant presents symptoms of GERD, it is important to get advice from a doctor or pediatrician as other, more severe, conditions share some of the symptoms of reflux in infants. Reflux usually doesn’t need any specific treatment but the feeding suggestions above might be helpful.

Approximately 85% of infants vomit during the first week of life, and 60-70% manifest clinical gastroesophageal reflux at age 3-4 months. Gastroesophageal reflux is most commonly seen in infancy, with a peak at age 1-4 months. However, it can be seen in children of all ages, even healthy teenagers. Although the relationship between gastroesophageal reflux and ALTEs is controversial, where an association with apnea has been found, it is as likely to occur with nonacid as with acid reflux. Accordingly, a comprehensive evaluation of this phenomenon will likely require a bioelectrical impedance study (to identify nonacid reflux; see below) in conjunction with respiratory monitoring.

Baby reflux signs and symptoms

This causes nausea, vomiting, and heartburn. Aside from the lack of strong evidence, this treatment has some significant drawbacks. Introducing solid food too early replaces human milk, which is nutritionally ideal for babies, with a food of less nutritional value. It will also lower a mother’s milk supply. Regurgitating solids can add to the baby’s distress and discomfort, and introducing solids too early might also trigger allergies in an already sensitive baby.

What are the symptoms of GERD? Take the quiz to find out.

Don’t interrupt active suckling just to switch sides. Switching sides too soon or too often can cause excessive spitting up (see Too Much Milk?). For babies who want to breastfeed very frequently, try switching sides every few hours instead of at every feed. Although seldom seen in breastfed babies, regular projectile vomiting in a newborn can be a sign of pyloric stenosis, a stomach problem requiring surgery.

Based on the visit, he or she will decide whether your child may benefit from additional testing or from the addition of or a change in medications. In older children, diet can play more of a role. Large meals and highly acidic or spicy meals, as well as carbonated or caffeinated beverages, can lead to increased GER symptoms. In addition, GER is more common in children who are overweight or obese.

Most episodes resolve by 12 months of age. GER may occur in both breastfed and/or formula fed infants. Several studies document that breast fed infants empty their stomach faster than formula fed infants and are thus less likely to experience GER symptoms.

How is reflux diagnosed in a child?

The main sign of gastro-oesophageal reflux is frequent spitting up or regurgitation after feeds. This is often accompanied by abdominal pain or general crankiness in the hours after feeding.

In addition, every baby is different, and some of these tips may work better than others. Fortunately, reflux often improves as a baby gets older, and for those in which it persists, there are a variety of treatment options. Please remember that if you have any questions about your baby’s health-no matter how seemingly small-it’s always a good idea to consult with your pediatrician.

You could ask your GP about giving your baby an infant antacid. Antacid helps to neutralise the acid in your baby’s stomach, so it shouldn’t be as painful for him if he brings it up (NHS 2016b) . It may also be combined with an alginate, which is a medicine that helps to keep milk and acid in your baby’s stomach in the first place (NHS 2016a, NICE 2015a,b) .

The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children’s Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.

Barrett esophagus

Reflux isn’t necessarily a bad thing for babies. If they have swallowed a large amount of milk (and air) during a feed, reflux is a way the body can help to reduce the pressure, and relieve the discomfort of an overfull stomach. GERD and LPR are usually suspected based on symptoms, and can be further evaluated with tests such as an endoscopic examination (a tube with a camera inserted through the nose), biopsy, special X-ray exams, a 24-hour test that checks the flow and acidity of liquid from your stomach into your esophagus, esophageal motility testing (manometry) that measures muscle contractions in your esophagus when you swallow, and emptying of the stomach studies. Some of these tests can be performed in an office. GERD and LPR can result from physical causes and/or lifestyle factors.

infant gerd symptoms

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