Infant reflux
Definition:
Infant reflux (sometimes called infant acid reflux) is the condition where the contents of the stomach are spit out, usually shortly after feeding. Spitting up (infant reflux) becomes less common as a baby gets older, and it's unusual if it's still occurring after 18 months of age.
In a small number of cases, reflux can be a sign of a more serious problem, such as gastroesophageal reflux disease (GERD), an allergy or a blockage.
Symptoms:
Spitting up and vomiting are the main symptoms of infant reflux. As long as your baby is healthy, content and growing well, the reflux is not a cause for concern. Your child will in all likelihood outgrow it.
While your baby may act fussy or seem to be uncomfortable, it is very unusual for the stomach contents to be acidic enough to irritate the esophagus or throat, as happens with acid reflux.
When to see a doctor
Contact your baby's doctor if your baby:
Causes:
Infant reflux is related to a number of factors, often in combination with one another.
In infants, the ring of muscle between the esophagus and the stomach — the lower esophageal sphincter (LES) — is not yet fully mature, allowing stomach contents to flow backward. Eventually, the LES will open only when baby swallows and will remain tightly closed the rest of the time, keeping stomach contents where they belong.
Babies are lying flat most of the time, which makes reflux more likely. Moreover, their diet is completely liquid, also favoring infant reflux. Sometimes air bubbles in the stomach may push liquids backward. In other cases, your baby may simply drink too much, too fast.
Although infant reflux most often occurs after a feeding, it can happen anytime your baby coughs, cries or strains.
In a small number of cases, the symptoms of infant reflux are caused by something else. Among the possibilities:
Most cases of infant reflux clear up on their own without causing problems for your baby.
If the condition is not normal reflux, but is GERD or some other condition (much less common), the baby may show signs of poor growth or problems with breathing. Some research indicates that babies who have frequent episodes of spitting up may be more likely to develop gastroesophageal reflux disease during later childhood.
Treatments and drugs:
Most cases of infant reflux clear up on their own, helped by simple changes in feeding techniques, such as:
If you feed your baby formula, sometimes switching brands helps.
Definition:
Infant reflux (sometimes called infant acid reflux) is the condition where the contents of the stomach are spit out, usually shortly after feeding. Spitting up (infant reflux) becomes less common as a baby gets older, and it's unusual if it's still occurring after 18 months of age.
In a small number of cases, reflux can be a sign of a more serious problem, such as gastroesophageal reflux disease (GERD), an allergy or a blockage.
Symptoms:
Spitting up and vomiting are the main symptoms of infant reflux. As long as your baby is healthy, content and growing well, the reflux is not a cause for concern. Your child will in all likelihood outgrow it.
While your baby may act fussy or seem to be uncomfortable, it is very unusual for the stomach contents to be acidic enough to irritate the esophagus or throat, as happens with acid reflux.
When to see a doctor
Contact your baby's doctor if your baby:
- Isn't gaining weight
- Spits up forcefully, causing stomach contents to shoot out of his or her mouth (projectile vomiting)
- Spits up green or yellow fluid
- Spits up blood or a material that looks like coffee grounds
- Refuses food
- Has blood in his or her stool
- Has difficulty breathing
- Begins vomiting at age 6 months or older
Causes:
Infant reflux is related to a number of factors, often in combination with one another.
In infants, the ring of muscle between the esophagus and the stomach — the lower esophageal sphincter (LES) — is not yet fully mature, allowing stomach contents to flow backward. Eventually, the LES will open only when baby swallows and will remain tightly closed the rest of the time, keeping stomach contents where they belong.
Babies are lying flat most of the time, which makes reflux more likely. Moreover, their diet is completely liquid, also favoring infant reflux. Sometimes air bubbles in the stomach may push liquids backward. In other cases, your baby may simply drink too much, too fast.
Although infant reflux most often occurs after a feeding, it can happen anytime your baby coughs, cries or strains.
In a small number of cases, the symptoms of infant reflux are caused by something else. Among the possibilities:
- Allergic gastroenteritis is an intolerance to something in food, usually a protein in cow's milk.
- Gastroesophael reflux disease (GERD) is a more severe condition where the reflux is acidic enough to actually irritate and damage the lining of the esophagus.
- Eosinophilic esophagitis is a condition where a particular type of white blood cell (eosinophil) builds up and injures the lining of the esophagus.
- Obstruction is a blockage or narrowing in the esophagus (esophageal stricture) or between the stomach and small intestine (pyloric stenosis).
Most cases of infant reflux clear up on their own without causing problems for your baby.
If the condition is not normal reflux, but is GERD or some other condition (much less common), the baby may show signs of poor growth or problems with breathing. Some research indicates that babies who have frequent episodes of spitting up may be more likely to develop gastroesophageal reflux disease during later childhood.
Treatments and drugs:
Most cases of infant reflux clear up on their own, helped by simple changes in feeding techniques, such as:
- Smaller, more frequent feedings
- Thickening feedings with cereal
- Interrupting feedings to burp the baby
- Holding your baby upright during and after feedings
If you feed your baby formula, sometimes switching brands helps.
-
Medication. Acid-blocking medications are not
recommended in cases of uncomplicated infant reflux. A short-term trial
of an H-2 blocker such as ranitidine, or perhaps a proton pump inhibitor
such as omeprazole (Prilosec) or lansoprazole (Prevacid), may be worth
trying for babies who have poor weight gain, refuse to feed, have
evidence of esophagitis or who have chronic asthma and reflux.
It's important to note that otherwise healthy children taking these medications may face an increased risk of certain intestinal and respiratory infections. In addition, prolonged use of proton pump inhibitors has been linked to problems in iron and calcium absorption in infants.
- Surgery. In rare instances, the muscle that relaxes to let food into the stomach (the lower esophageal sphincter) needs to be surgically tightened to prevent acid from flowing back into the esophagus. This fundoplication procedure is usually reserved for the few babies who have reflux severe enough to interfere with breathing or prevent growth.
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