Make sure your baby’s diaper is not too tight since this can exacerbate reflux. Some babies who have GER may not vomit, but may still have stomach contents move up the esophagus and spill over into the windpipe (the trachea). This can cause wheezing, pneumonia, and in very rare cases, a possibly life-threatening event. Raising Children Network is supported by the Australian Government.
It usually gets better on its own, and doesn’t often need any tests or treatment. The signs of silent reflux in babies aren’t always obvious. Here’s how to tell if your baby is silently suffering-and how to make her feel better. Treatment for GER depends on the type and severity of the symptoms. Some babies with reflux may not vomit.
Burping your infant several times during the feeding (after every ounce or two) will help minimize gastric pressure and the reflux it can cause. Waiting to burp your infant until after she has a full stomach can increase the chances of regurgitation.
What are some of the symptoms of GERD in children?
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. 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.
Some people with GERD have a slow emptying of the stomach that may be contributing to the reflux of acid. During this test, your child drinks milk or eats food mixed with a radioactive chemical. This chemical is followed through the gastrointestinal tract using a special camera.
The options for treating gastro-oesophageal reflux disease are improving all the time, with new medicines and surgical options being discovered alongside a better understanding of why a child develops gastro-oesophageal reflux disease. Medications may also be suggested – some form a barrier on top of the stomach contents to reduce the risk of them flowing backwards, while others damp down acid production in the stomach. Another type of medication speeds up the rate at which feed passes from the stomach into the duodenum and intestines. All these medications take some time to work but can be very helpful for the majority of children.
When GERD is suspected, many doctors first try a trial of various reflux medications (without running tests), to see if the medications improve babyâ€™s symptoms. If testing is done, a 24-hour pH probe study () is the current â€œgold standardâ€ for reflux testing in babies; this is a procedure where a tube is placed down babyâ€™s throat to measure the acid level at the bottom of the esophagus.
Babies with reflux may be irritable, spit up or refuse to eat. They arch their bodies during or after feedings, or cry when placed on their backs, especially if they just ate.
You will need to keep a diary of any symptoms your child feels that may be linked to reflux. These include gagging or coughing. You should also keep a record of the time, type of food, and amount of food your child eats. Your childâ€™s pH readings are checked. They are compared to your childâ€™s activity for that
Allergic babies generally have other symptoms in addition to spitting up. Babies with Gastroesophageal Reflux Disease (GERD) usually spit up a lot (see below). Reflux in babies can be very frustrating, and there is rarely one step alone which helps.
No blood or X-ray tests are indicated. Infants experiencing GERD have often a forceful ejection of stomach contents, have periods between feeding of agitation and fussiness, may have episodes of arching twisting between feedings, and may have slow weight gain due to inadequate caloric intake. Recurrent cough or (in rare cases) wheezing may be associated with GERD. In some circumstances radiology or other studies may be necessary.
Your GP will only prescribe these if your baby has a sore food-pipe from the amount of stomach acid he’s bringing up. They’re not suitable if your baby has reflux, but no other symptoms (NICE 2015b, Rosen et al 2018) . If antacids don’t help, you could ask your doctor about treatment with another heartburn and indigestion medication, called ranitidine, or a proton pump inhibitor (PPI), such as omeprazole. These medicines reduce the amount of acid your baby’s stomach makes by blocking the actions of acid-producing cells (Ogbru 2016, 2018) .
This may happen when baby feeds very quickly or aggressively, or when momâ€™s breasts are overfull. The amount of spitup typically appears to be much more than it really is. If baby is very distractible (pulling off the breast to look around) or fussy at the breast, he may swallow air and spit up more often. Some babies spit up more when they are teething, starting to crawl, or starting solid foods. Spitting up, sometimes called physiological or uncomplicated reflux, is common in babies and is usually (but not always) normal.
Many babies with reflux gradually improve as they grow, particularly when they start to eat more solid food and feed in an upright position in a high chair for instance. They work by forming a protective layer on a babyâ€™s mucous membranes which line the gut, respiratory tract and other areas. This stops micro-organisms from invading the body through these mucous membranes. Dr. Newman explains that a baby who spits up gets double protection, first when the milk goes down to the stomach, and again when he spits it up. If a baby continues to be distressed, then a doctor may refer you to a gastroenterologist who may prescribe medications which can help.