If a child has severe gastro-oesophageal reflux which is not controlled with medication or is causing significant complications, your doctor may recommend an operation called a fundoplication to prevent reflux. Before reaching this decision, the severity of the child’s reflux will usually be assessed with an upper GI contrast study and a pH or impedance study. As every child is different, the decision to recommend surgery will only be made after these assessments have been completed.
If your baby is breastfed, try pumping and then adding rice cereal to the breast milk. Having an infant sleep on her stomach is only considered in very unusual cases in which the risk of death from complications of GERD outweighs the potential increased risk of SIDS. Always place your baby to sleep on her back unless your pediatrician has told you otherwise. Holding infants in an upright position both during feedings and for at least 30 minutes after feedings will help to reduce the amount of gastric reflux.
What can I do to minimize spitting up/reflux?
The tube is then put through the food pipe or esophagus, and into the stomach. Your baby can have a tube feeding in addition to a bottle feeding. Or a tube feeding may be done instead of a bottle feeding. There are also tubes that can be used to go around, or bypass, the stomach.
Normally when swallowing, the esophagus propels food or liquid down to the stomach by a series of squeezes. In the stomach, the food is digested by acid. When this mixing occurs, the band of muscles at the lower end of the esophagus becomes tight, sealing off the food from coming back up.
- Reflux usually doesn’t need any specific treatment but the feeding suggestions above might be helpful.
- National Institutes of Health, National Library of Medicine, ENT Manifestations of Gastro-oesophageal Reflux in Children, October 2006.
- Put baby to sleep on his or her back.
- H2 blockers decrease acid production.
Sometimes babies may have signs of reflux, but will not bring up milk or be sick. This is known as silent reflux.
Frequent spitting up or vomiting; discomfort when spitting up. Some babies with GERD do not spit up – silent reflux occurs when the stomach contents only go as far as the esophagus and are then re-swallowed, causing pain but no spitting up. A small percentage of babies experience discomfort and other complications due to reflux – this is called Gastroesophageal Reflux Disease. 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.
Studies report that 15 to 40 percent of infants with reflux have a cow’s milk protein intolerance. This intolerance usually improves naturally by around 12 months, but in the mean time, breastfeeding moms can try eliminating milk products from their diet. Moms may need to eliminate soy products, as well. Talk to your healthcare provider before deciding if further foods should be eliminated (mom’s nutrition is very important, too!).
But occasionally, frequent and persistent spitting up accompanied by other symptoms or poor weight gain can be an indication that your baby has acid reflux, or GERD. Here’s how you can tell the difference between normal spitting up in babies and GERD.