Pediatric gastro-esophageal reflux disease –how to spot it and what to do

An American Gastroente-rological Association (AGA) employee was aware that gastroesophageal reflux disease (GERD) affects adults but never expected her newborn son, Ian, to be diagnosed. Soon after birth, Ian cried and refluxed ceaselessly and required suctioning of vomit from his throat to prevent choking. Once home, Ian continued to reflux massively, prompting a return to the hospital, where he was diagnosed with pediatric GERD. All infants experience gastroesophageal reflux (GER), such as splitting up after eating, but the ‘D’ (for disease) is added when symptoms, such as continuous vomiting or wheezing, become disruptive according to an AGA member, an associate editor and pediatric gastroenterologist at the Children’s Hospital in Birmingham, Ala. Some common symptoms of infant GERD include non-stop crying or irritability and excessive spitting up or vomiting an hour or more after feeding. Less obvious signs are from "silent reflux" and include a hoarse cry, refusal of food or arching of the back during feeding. Though rare, reflux can be so severe that infants fail to grow and require surgery or feeding tubes. Noted that most infants outgrow reflux by age one. In most cases, symptoms are enough for diagnosis; however, your doctor may offer further confirmation with one of several tests. Treating reflux is usually a case of trial and effort. The first actions parents can take are to alter feeding and positioning. Offer small, frequent bottles or meals and make sure the infant is burpsed afterwards. Thickening formula helps keep food down, and switching to hypoallergenic formula may be helpful to rule out milk or soy protein intolerance. However, milk intolerance is rarely a cause of reflux. Hold the infant upright during and for 30 minutes after feeding. Elevation of the head of the mattress 10 to 15 degrees during sleep may also be helpful. Infants with reflux should sleep on their side or back unless otherwise recommended by your physician. And, avoid stuffed animals or flannel sheets in the infant’s bed.

Commonly prescribed medications include H2RA PPT. None of these medications actually targets the mechanism of reflux. Thus, they may or may not affect the frequency or volume of vomiting. Medications are primarily to treat or prevent complications of reflux. There is no one magic cure. The hallmark of reflux is good day, bad day. This is found to be true. Pediatric GERD message boards armed her with questions to ask doctor. Why some people have GERD but others do not is a mystery. A recent study suggests heredity, but more research is needed. It is believed infant reflux is due mainly to an immature digestive system, a condition that infants will outgrow over time. With so many questions surrounding cause and treatment, handling infant GERD can be frustrating for baby, parents and pediatrician. Today Ian’s condition has improved, but not without trial and error. Our advice to those infants who may be suffering from GERD is to stay the course and find the right combination. Keep pressing the issue if something isn’t right, keep in touch with your doctor.