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Diagnosis and Management of Gastroesophageal Reflux in Preterm Infants

What are the symptoms of reflux in a young child?

The results were recently published in Journal of Pediatric Gastroenterology and Nutrition. Tube feedings.

Feed your baby in an upright position. Also hold your baby in a sitting position for 30 minutes after feeding, if possible. Gravity can help stomach contents stay where they belong. Be careful not to jostle or jiggle your baby while the food is settling. Your baby’s treatment will be designed to help relieve the symptom that was causing them the most problems (irritability, poor growth, or breathing problems).

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. Stomach acid might irritate the esophagus, larynx, and, if aspiration occurs, the airways. Esophageal irritation may decrease food intake as infants learn to avoid reflux by eating less.

Reflux happens because muscles at the base of your baby’s food pipe have not fully developed, so milk can come back up easily. If the thickening powder does not help or your baby is breastfed, a GP or specialist might recommend medicines that stop your baby’s stomach producing as much acid. Your baby does not usually need to see a doctor if they have reflux, as long as they’re happy, healthy and gaining weight. Reflux is when a baby brings up milk, or is sick, during or shortly after feeding.

What Are the Symptoms of GERD in Children and Infants?

Part of the evaluation of an infant who may have GER is to rule out pyloric stenosis. Pyloric stenosis is the thickening of the region of the stomach (pyloris) as it transitions into the first section of the small intestine. Studies show that most infants with pyloric stenosis have recurrent symptoms of forceful emesis shortly after a meal. The child is content until just before vomiting generally. There is a genetic predisposition favoring the first-born male.

He is an Associate Professor of Pediatrics and Associate Clinical Chief of Pediatric Gastroenterology at Yale University and Director, Pediatric Gastroenterology at Greenwich Hospital in Greenwich, CT. He is also the medical director of the Yale Pediatric Celiac Program. Within the American Academy of Pediatrics, Dr. Porto sits on the PREP Gastroenterology Advisory Board and is a known member of the Section on Gastroenterology, Nutrition and Hepatology.

What to expect from your doctor

This causes nausea, vomiting, and heartburn. Reflux can happen at any age, but it’s common in babies.

can be considered, although there are few data on PPI use in infants. PPIs are more effective at suppressing gastric acid than are H2 blockers and are given only once/day.

The vertical dashed arrow indicates the onset of a normal swallow. Despite the immense volume of data examining diagnosis, prognosis and management related to pediatric gastroesophageal reflux, a recent review of 46 articles (out of more than 2400 publications identified) demonstrated wide variations and inconsistencies in definitions, management approaches and in outcome measures. During infancy, the prognosis for gastroesophageal reflux resolution is excellent (although developmental disabilities represent an important diagnostic exception); most patients respond to conservative, nonpharmacologic treatment. Symptoms abate without treatment in 60% of infants by age 6 months, when these infants begin to assume an position and eat solid foods upright. Resolution of symptoms occurs in approximately 90% of infants by age 8-10 months.

tests for gerd in infants

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