Symptoms & Causes of GER & GERD in Infants

Baby cereal, added to thicken breastmilk or formula, has been used as a treatment for GER for many years, but its use is controversial. If your child is taking reflux medications, keep in mind that dosages generally need to be monitored and adjusted frequently as baby grows. Although recent research does not support recommendations to keep baby in a semi-upright position (30° elevation), this remains a common recommendation.

Other causes include food allergies, most commonly milk allergy. A less common cause is gastroparesis (delayed emptying of the stomach), in which food remains in the stomach for a longer period of time, maintaining a high gastric pressure that predisposes to reflux. Infrequently, an infant can have recurrent emesis that mimics GERD because of a metabolic disease (eg, urea cycle defects, galactosemia, hereditary fructose intolerance) or an anatomic abnormality (such as pyloric stenosis or malrotation). FundoplicationFundoplication is a surgical procedure for treating GERD (gastroesophageal reflux disease). The procedure is to help GERD symptoms including heartburn.

Babies and children can also go through quite normal phases where the problem appears to be improving and then re-occurs quite suddenly, sometimes for no apparent reason. Most babies with reflux gain weight well; however, some babies do not gain weight at the expected rate and some may fail to thrive. This may be the result of feeding difficulties, frequent vomiting or other issues.

In fact, studies now show that even babies who do have severe reflux usually have no pain. Out of 219 babies hospitalized because of severe reflux, 33% had excessive vomiting and 30% were failing to gain weight but few had just excessive crying.

The doctor will check your baby’s growth and development, and if necessary they will refer you to a paediatrician. Further tests may be arranged if your doctor is concerned. It is possible to reduce the number of reflux episodes holding your baby in a more upright position when feeding. Try keeping them upright for about 20 minutes after their feed. I have a 6week old and I’m a new mom, I have been to see my GP about my baby’s feeding, as it has become a problem Togo to the toilet and also she suffers from severe colic.

These babies have been termed by some as ‘Scrawny Screamers’ (as compared to the Happy Spitters). There seems to be a family tendency toward reflux. GERD is particularly common in preemies (due to their immaturity) and in babies with other health problems. GERD usually improves by 12-24 months. Premature babies are more likely to be affected by GORD (NICE 2015a, Rosen et al 2018) .

A small tube with a camera on the end is placed into one of the incisions to look inside. The surgical tools are put through the other incisions. The surgeon looks at a video screen to see the stomach and other organs. The top part of the stomach is wrapped around the esophagus.

Most episodes resolve by 12 months of age. GER may occur in both breastfed and/or formula fed infants. Several studies document that breast fed infants empty their stomach faster than formula fed infants and are thus less likely to experience GER symptoms.

Usually, babies with reflux don’t need any tests as the condition can be diagnosed based on their symptoms. But in rare cases and if a healthcare professional thinks they might be helpful, an endoscopy, pH monitoring or barium swallow test can be done (NICE, 2015; NHS, 2016) . Sometimes babies don’t spit out what comes back up but swallow it instead. This is known as ‘silent reflux’. Babies with silent reflux might gain weight normally but show some of the symptoms as reflux (NHS start4life, 2019) .

If the muscle between the esophagus and the stomach (lower esophageal sphincter) relaxes at the wrong time, stomach contents might flow up the baby’s esophagus. Researchers aren’t sure whether decreasing stomach acid lessens reflux in infants. During the test, your child is asked to swallow a long, thin tube with a probe at the tip that will stay in the esophagus for 24 hours.

GERD occurs when contents in the stomach (usually the stomach acid and formula) moves backwards into the esophagus. Gastroesophageal reflux disease (GERD) is a disease that involves the esophagus and stomach. Treatment for children with GERD can include over-the-counter medications, prescription medications, and surgery for severe cases. Without getting too technical, spit-up (also called reflux, gastroesophageal reflux, or GER) is the movement of stomach contents into the esophagus, and sometimes through the mouth and nose. When reflux is associated with other symptoms, or if it persists beyond infancy, it is considered a disease and is known as gastroesophageal reflux disease or GERD.

In some cases tube feedings may be recommended. Some babies with reflux have other conditions that make them tired. These include congenital heart disease or being born too early (premature). These babies often get sleepy after they eat or drink a little.

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- October 27, 2015

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