Reflux, or gastroesophageal reflux disease (GERD), affects more than half of all babies under the age of 3 months, according to the National Digestive Diseases Information Clearinghouse (NDDIC). Although the disease itself is not usually life-threatening, it is uncomfortable for the baby and can lead to other health difficulties. Luckily, serious cases of GERD are rare. Most infants outgrow reflux by the time they are 18 months old.
Reflux occurs when gastric acid flows up from the stomach into the esophagus. A muscular valve called the lower esophageal sphincter (LES) is located between the stomach and esophagus. This ring of muscle opens to allow gas to escape the body (which happens when you burp). The LES is supposed to allow gas to escape but keep stomach acids where they belong. In young infants, however, the valve sometimes doesn’t work properly. It also sometimes opens when a baby cries or strains, according to NDDIC. Once the muscle is open, stomach acids may rise and burn the esophagus.
Symptoms of reflux in babies range from mild to serious. Babies with mild cases are fussy, especially after eating, and may suffer from crying jags that have no apparent cause. They may also spit up more often than other babies, or vomit more frequently. Babies suffering from reflux also tend to get the hiccups more often. Babies with serious cases of GERD may stop gaining weight, refuse to eat and may even develop pneumonia, asthma and ulcers, according to the University of Rochester Medical Center.
Diagnosis of reflux is usually done by listening to the parents talk about the child’s symptoms, according to WebMD. Sometimes, testing is done to confirm a diagnosis. The child may be asked to swallow barium and then sit for an X-ray to make sure nothing is blocking the esophagus or stomach. In severe cases, an endoscope may be used to look inside the esophagus, stomach or the upper part of the gastrointestinal tract.
Steps can be taken at home to reduce the incidences of reflux and the severity of symptoms. Breastfeeding babies suffer less from reflux than their formula-feeding counterparts, according to AskDrSears.com. Keeping a baby upright for 30 minutes after feeding can help aid in digestion, and smaller feedings can also help prevent reflux. Babies diagnosed with severe reflux will sleep better on their stomachs, on a mattress propped up at a 30-degree angle. Babies without severe reflux should be placed on their backs to sleep. Medications called H2-blockers are sometimes prescribed if reflux is interfering with growth. Proton-pump inhibitors (PPIs) are stronger medications prescribed for babies with severe GERD.
While PPIs are considered safe, they may cause liver and stomach problems if used for a long time, according to Dr. Samuel Nurko of Children’s Hospital Boston. For that reason, PPIs should only be used in cases where the baby has been diagnosed with severe reflux. In addition, babies and children who are taking PPIs should be monitored by a gastroenterologist.