Infant Acid Reflux
Introduction
Infant acid reflux — more accurately known as gastroesophageal reflux — is a common problem. In fact, more than half of all babies experience reflux during the first few months of life, according to the National Digestive Diseases Information Clearinghouse.
Although infant acid reflux is most likely after a feeding, it can happen anytime your baby coughs, cries or strains. And it's probably tougher on you than on your baby. Even when soaked in spit up, most babies who have reflux are happy and healthy.
Infant acid reflux typically resolves on its own by ages 12 to 18 months. In the meantime, changes in feeding technique — such as smaller, more frequent feedings, changing position or interrupting feedings to burp — can help keep reflux under control. In a few cases, medication or other treatments may be recommended.
Signs and symptoms
Spitting up is the classic sign of infant acid reflux. Irritability during feedings and poor feedings also are common.
Causes
Normally, the ring of muscle between the esophagus and the stomach relaxes and opens only when you swallow. Otherwise, it's tightly closed — keeping stomach contents where they belong. Until this muscle matures, stomach contents may occasionally flow up the esophagus and out of your baby's mouth. Sometimes air bubbles in the esophagus may push liquid out of your baby's mouth. In other cases, your baby may simply drink too much, too fast.
Complications
Rarely, infant acid refluxx may lead to poor growth, breathing problems or blood loss from stomach acid irritating the esophagus. Some research indicates that people who develop GERD as infants or children may also experience the condition during adulthood.
Treatment
Most cases of infant acid reflux clear up on their own. Treatment is typically limited to simple changes in your feeding technique — such as smaller, more frequent feedings, interrupting feedings to burp or holding your baby upright during feedings. If you're breast-feeding, your baby's doctor may suggest that you avoid cow's milk or certain other foods. If you feed your baby formula, sometimes switching brands helps.
For babies with severe reflux or GERD, more aggressive treatment may be needed.
- Medication. If your baby is uncomfortable, the doctor may prescribe infant doses of medications commonly used to treat heartburn in adults. Choices may include H-2 blockers, such as cimetidine (Tagamet) or ranitidine (Zantac), or proton pump inhibitors, such as esomeprazole (Nexium) or omeprazole (Prilosec). Although these medications are considered safe for use in infants and children with GERD, a 2006 study noted an increased risk of intestinal and respiratory infections in otherwise healthy children taking these medications.
- Alternative feeding methods. If your baby isn't growing well, higher calorie feedings or a feeding tube may be recommended.
- Surgery. Rarely, the muscle that relaxes to let food into the stomach (the lower esophageal sphincter) must be surgically tightened so that less acid is likely to flow back into the esophagus. The procedure, known as fundoplication, is usually reserved for the few babies who have reflux severe enough to interfere with breathing or prevent growth. Although surgery can reduce GERD symptoms, the complications are potentially serious — including persistent gagging during feedings.
Credit: National Institute of Health.