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Infant Acid Reflux

Definition


Disease: Infant Acid Reflux Infant Acid Reflux
Category: Children diseases

Disease Definition:

A common problem seen in more than half of babies during the first three months of life, when the baby seems to be spitting up more often than normal, is gastroesophageal reflux, or infant acid reflux. Infant acid reflux may occur at anytime the baby coughs, strains or cries, even though the condition has a great likelihood of occurring after a feeding. This condition is known to be more difficult a situation on the parent rather than the baby itself. Most babies experiencing infant acid reflux are healthy and content even though they are soaked in spit up.

 

Infant acid reflux commonly goes away on its own by ages 12 to 18 months. Reflux may be managed in the meanwhile by making changes in feeding methods; for instance, smaller, more frequent feedings, interrupting feedings to burp, or changing position. Medication or other treatments may be recommended in a few cases.
 

Work Group:


Symptoms, Causes

Symptoms:

The following are signs of infant acid reflux:

  • Irritability during or after feedings
  • Poor feedings
  • Spitting up

 

Normal infant acid reflux doesn’t interfere with a baby’s development or well-being. Parents should consult a doctor when their baby:

  • Spits up more than a tablespoon or two at a time
  • Resists feedings
  • Spits up forcefully, resulting in stomach contents to shoot out of their mouth
  • Has fewer wet diapers than normal or seems lethargic
  • Spits up green or brown fluid
  • Has other signs of illness, like diarrhea, difficulty breathing, or fever
  • Is irritable after feedings but improves when held upright
  • Isn’t gaining weight

 

More serious conditions like Pyloric stenosis or gastroesophageal reflux disease (GERD) may be indicated by some of these signs. Pyloric stenosis is a rare condition in which a narrowed valve between the stomach and the small intestine prevents stomach contents from emptying into the small intestine. GERD is a severe version of reflux that can result in pain, poor weight gain and vomiting.
 

Causes:

The ring muscle between the esophagus and the stomach (lower esophageal sphincter) relaxes and opens only when one swallows under normal circumstances. Otherwise, it is tightly shut, keeping stomach contents where they belong. Stomach contents may sometimes flow up the esophagus and out of the baby’s mouth until the muscle matures. The air bubbles found in the esophagus may occasionally push liquid out of the baby’s mouth. In other cases, the baby may simply be drinking too much in a rapid way.
 

Complications

Complications:

Infant acid reflux mostly goes away on its own without resulting in problems for the baby. This condition rarely contributes to poor growth or breathing problems. Certain research indicates that gastroesophageal reflux disease may develop during later childhood in babies who have had frequent episodes of infant acid reflux.
 

Treatments:

Infant acid reflux may be treated simply with changes in feeding methods, since this condition mostly goes away on its own. For instance, smaller more frequent feedings, holding the baby upright during feedings or interrupting feedings to burp may be helpful methods. The baby’s doctor may suggest that the mother avoid cow’s milk or some other foods in case she’s breast-feeding. When a mother feeds her baby formula, switching brands may sometimes be beneficial. More aggressive treatment may be recommended for babies who experience GERD or severe infant acid reflux.

 

Medication:

Infant doses of medications commonly used to treat heartburn in adults may be prescribed if the baby is uncomfortable. H-2 blockers, like ranitidine or cimetidine may be included among these medications, or proton pump inhibitors like lansoprazole or omeprazole. There’s the likelihood of experiencing certain risks of intestinal and respiratory infections for children who are healthy but have taken these medications.

 

Alternative feeding methods: 

A feeding tube or higher calorie feedings may be recommended in case the baby isn’t growing well.

 

Surgery:

When a baby has reflux severe enough to interfere with breathing or prevent growth, a procedure called fundoplication may be recommended. In some rare cases, 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. Even though surgery is able to decrease GERD symptoms, but it can cause possibly serious complications such as persistent gagging during feedings.
 

Prognosis:

Not available

Expert's opinion

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