Gastroesophageal Reflux (GER) or Acid Reflux in Infants

Have you noticed a baby spitting up or shooting out the milk, food or stomach content after a meal? It could be acid reflux in in infant, also known as Gastroesophageal Reflux (GER).

Sometimes a baby spits up after having food or liquid or after a meal. We know this health condition in babies as infant acid reflux or acid reflux in infants. After your baby has a meal, the stomach contents move back up from the stomach to the infant’s mouth through the esophagus. Esophagus or oesophagus is a muscular tube that connects your baby’s mouth and the stomach.

Is Gastroesophageal Reflux Disease (GERD) the same as Acid Reflux in infant?

Since acid reflux involves the esophagus for the stomach content to move back up to the mouth that your baby spits up, it is called gastroesophageal reflux (GER), commonly known as acid reflux in infants. Gastroesophageal reflux disease (GERD) is a severe health condition of GER in children if diagnosed.

What age group & health condition of infants are likely to have acid reflux?

Reflux can occur many times a day in healthy babies. It is more prevalent in babies and infants and vanishes as they grow older. Although it is common to see reflux in your baby for less than 18 months, it is unusual to continue after 18 months.

If you observe weight loss or inadequate growth compared to other babies of the same age and sex, reflux could rarely be one reason. The other reasons, apart from gastroesophageal reflux disease (GERD), could be an allergy or digestive system blockages.

IS GER/Acid Reflux a severe health condition in infants?

Acid reflux is not a severe health concern for your baby if she is healthy and growing well with no existing pre-diagnosed health condition. The reflux gradually decreases as your baby grows older. You may see a health specialist if reflux persists after a certain age.

How can you try to prevent reflux in your baby?

Infant Acid Reflux is common in babies, and one cannot do much to stop it. But we can avoid some factors to protect the baby from reflux.

• Position the baby flat during sleeping or lying while resting. Ensure your baby sleeps on the back (not side/front)

• Refrain from feeding the baby with a wholly liquid diet.

• Maintain an upright position while feeding your baby

• Encourage smaller and more frequent feeding

• During the feed, take time to burp your baby

• Give formula-fed babies smaller meals

What are the common symptoms of acid reflux in children?

You may consult your doctor if you see the symptoms −

• Not gaining weight according to the age

• Spit up forcefully, shoot out the stomach out of the mouth, also known as projectile vomiting

• Stomach content appears as fluid in green or yellow

• Spitting up blood or shooting out stomach content as coffee grounds

• Does not eat or feed

• Blood in stool/poo

• Has swollen or tender tummy

• Breathing difficulty or consistent cough for a longer time

• Spitting up starts after attaining six months or older

• Irritable after a meal, won’t stop crying, very distressed

• Consistently lack of energy

• Diarrhoea lasting more than a week and dehydration symptoms

• Sick, feeling hot or shivery

• Coughing or hiccups when fed

• Unsettled during feeding

• Silent Reflux

Are there more serious conditions that need medical intervention?

Some conditions are serious but treatable. But if the diagnosed blockage is in the digestive system or GERD, one must take the baby to a health specialist for diagnosis and treatment. Some conditions include −

GERD

It needs medical attention as the disease may have enough acid to harm the lining of the esophagus

Pyloric Stenosis

The muscular valve that enables food to enter the small intestine after leaving the stomach gets thickened and larger. It prevents the food in the stomach and blocks it from entering the small intestine.

Food Intolerance

The protein in cow’s milk causes it

Eosinophilic Esophagitis

Building up of a particular white blood cell type that damages the lining of the esophagus

Sandifer Syndrome

It is a rare condition in GERD where the head tilts or rotates like movements because of a seizure.

What are the Common Causes of Infant Acid Reflux?

Lower esophageal Sphincter (LES) not fully developed

The muscle (Lower esophageal Sphincter - LES) between the esophagus and stomach is yet to develop fully. LES opens when during the intake and closes fully at other times. LES not fully grown causes the stomach content moves back up into the esophagus. However, LES matures as the baby grows older.

Other factors that cause acid reflux in babies

• Premature birth

• Lung conditions affecting the baby’s nervous system, e.g. cerebral palsy

• The esophagus has undergone surgery earlier

When do you need a doctor for acid reflux?

If acid reflux is not improving even after trying to ease it, the physician suggests parents can go for treating reflux in their babies.

• First time experiencing acid reflux after the baby attained six months of age

• If reflux continues, even if the baby is over one year

• Weight variations upward and downward

How acid reflux in babies and children is medically diagnosed?

• Ultrasound

Imaging test to detect pyloric stenosis

• Lab Tests

Blood, stool and urine tests to identify the cause of the vomiting and weight loss.

• Esophageal pH monitoring

It measures acidity in the esophagus

• X-Rays

Images to detect problems in the baby’s digestive tract, like blockages

• Upper endoscopy

Samples of tissues taken for analysis

What are the treatments for Acid Reflux in Babies and Infants?

The good thing is that infant acid reflux cures on its own naturally. It is rare to see causing problems in babies.

For formula-fed babies, your physician may recommend

• A powder is mixed with formula to thicken the milk.

• Formula milk that is pre-thickened

If thickened milk does not work or you breastfed the baby, the physician may suggest medications.

Medications

• The physician may prescribe acid-blocking medications to block the acid formation in the baby’s stomach.

• Physicians administer medications to treat uncomplicated acid reflux in infants.

Surgery

• Physicians seldom recommend surgery for strengthening the muscles to prevent the backflow of food or liquid up the esophagus.

• It is only if the reflux is severe, not gaining weight or breathing trouble because of reflux.