As food or milk is digesting, the LES opens. It lets the stomach contents go back up to the esophagus. Sometimes the stomach contents go all the way up the esophagus.
However, keep an eye on your baby’s weight gain, as you may end up feeding too much. As long as your baby is gaining weight, eating well and not acting very upset, he or she will fall into the majority of infants who have “uncomplicated” reflux. This means they don’t have any worrisome symptoms other than the spitting-up episodes. These babies will have fewer episodes of reflux as they get older and will eventually outgrow their reflux.
Premature babies are more likely to be affected by GORD (NICE 2015a, Rosen et al 2018) . Babies with life-long medical conditions, such as cystic fibrosis, are also more likely to suffer from GORD (Rosen et al 2018) . What causes reflux?
The World Health Organization says that giving anything other than breast milk to infants younger than 6 months may increase the risk of bacterial infection, serious allergies, and stomach irritation. If given regularly, gripe water can also create significant problems with an infant’s blood chemistry. Your baby may be more likely to have reflux and to spit up when their stomach is too full. Increasing the frequency of feedings while decreasing the amount at each feed will likely help.
Thicker feeds encourage the milk to stay down in the stomach and make it harder to wash back up the oesophagus. But, thicker feeds can be harder for a baby to suck and swallow, and can affect the nutritional content of the formula. Similarly, reducing the volume of feeds might reduce reflux, but may also impact on the nutrition and growth of a baby. The number of feeds in a day may need to be increased if the volume of each feed is reduced. Alginate substances made for babies (such as gaviscon infant) work by thickening the feed and forming a coating over the lower oesophagus and stomach.
Anything that causes the muscular valve between the stomach and esophagus (the lower esophageal sphincter, or LES) to relax, or anything that increases the pressure below the LES, can cause GERD. Most of the time, reflux in babies is due to a poorly coordinated gastrointestinal tract. Many infants with GERD are otherwise healthy; however, some infants can have problems affecting their nerves, brain, or muscles. According to the National Digestive Diseases Information Clearinghouse, a child’s immature digestive system is usually to blame and most infants grow out of the condition by the their first birthday.
Start with one teaspoon of rice cereal to each ounce of formula. If your baby is breastfed, try pumping and then adding rice cereal to the breast milk. Even though the prone (on the stomach) sleeping position was recommended for babies with reflux in the past, this is no longer recommended. In fact, the evidence is quite strong that prone sleeping should be avoided if at all possible.
How to Choose the Right GERD Diet
Infants are more prone to acid reflux because their LES may be weak or underdeveloped. In fact, it’s estimated that more than half of all infants experience acid reflux to some degree. Acid reflux happens when the contents of the stomach back up into the esophagus. If these don’t help and your baby still has severe symptoms, then surgery might be an option. Pediatric gastroenterologists only use surgery to treat GERD in babies in rare cases.
For us, reflux is usually caused by lifestyle choices, such as eating heavy, fatty foods, smoking or drinking too much coffee. In grownups, unmistakable symptoms like heartburn and burping are signs of acid reflux. Some foods may cause more reflux symptoms than others, so keep track of your child’s intake for a few days to identify specific food triggers. Also keep in mind that children with GERD shouldn’t have any food in the two to three hours before bedtime. Emily Parks, a Halifax mom, knows this first-hand.
The procedure, called a Nissen fundoplication, involves wrapping the top part of the stomach around the lower esophagus. The displaced stomach contracts during the digestive process, and thus closes off the lower esophagus and prevents reflux. In extraordinary circumstances, a feeding tube directly into the stomach is necessary to complement the Nissen fundoplication.
The lower esophageal sphincter (the part of the body just above the stomach that clamps down and keeps the food you eat from coming up) is looser in babies. Infants can have their stomach contents pass into the esophagus up to 30 times a day. However, parents don’t notice every event. Sometimes, the milk will just hit the lower esophagus, then go back down into the stomach.
And one type of antacid even had to be pulled from the market because it was found to cause sudden death. The healthcare professional should talk with you about reflux and how common it is, give you advice and reassure you about it. This is because, for most babies, regurgitating feeds is completely normal and will disappear as the baby gets older. Some reflux – regurgitating or vomiting of feeds – is normal in babies.
It can happen multiple times a day, particularly after feeds. It happens when food is swallowed into the stomach, but then regurgitates back into the oesophagus (food pipe). Sometimes it then drops back into the stomach (and down the gastrointestinal tract) or sometimes it washes back up to the mouth or further, causing a vomit or spill of feed. Growth spurt – when babies start feeding more frequently with a growth spurt, they can be bringing in larger volumes of milk and/or more air.
How will my pediatrician evaluate my baby for GER?
Bloating is a sign and symptom of gas in the stomach or GI tract. Certain foods or health problems like constipation may cause it. Bacteria and certain foods like lactose can cause it. Learn the symptoms and causes of bloating to feel more healthy. Slower than normal emptying of stomach contents may predispose infants or children to GERD.
CMPA is more common in formula-fed babies than breastfed babies (Breastfeeding Network 2017) . If your baby is formula-fed, ask your doctor about giving him a hypoallergenic formula for a couple of weeks to see if it helps (Rosen et al 2018) . If you breastfeed your baby, ask your doctor’s advice about cutting out milk and other dairy products like cheese and yoghurt, so they can’t get into your breastmilk (Rosen et al 2018) . Sometimes, the symptoms of cow’s milk protein allergy (CPMA) can be similar to the symptoms of reflux, particularly in babies under six months of age (Ferreira et al 2014, Rosen et al 2018) .