The
food that we eat enters the stomach through a tube
called the esophagus. A ring of muscles known as
the lower esophageal sphincter opens to allow food
to enter the stomach. It normally opens to release
gases after a meal. In case of infants the
contents reflux out of the mouth and cause
vomiting or regurgitation. Acid reflux is
common in infants and occurs during the first
three months of age. Usually symptoms disappear by
18 months. However, at times the symptoms of acid
reflux are severe requiring medical evaluation and
treatment.
Symptoms
of acid reflux in infants are:
1.
Frequent
spitting or vomiting.
2. Refusing
food or eating only small
quantities.
3.
Irritability.
4.
Constant crying.
5.
Frequent hiccups pr coughing.
6.
Poor sleep habits.
7.
Bad breath.
8.
Difficulty swallowing due to frequent sore
throat.
9.
Respiratory problems and sometimes spells of not
breathing.
10.
Excessive drooling.
If
the infant is healthy, content, and growing well
no diagnostic tests or treatment is necessary as
the symptoms may resolve with time. However, if
the doctor suspects an underlying serious
condition blood and urine tests, esophageal pH
monitoring, upper GI series, etc. may be ordered.
In rare cases an endoscopy may be done to rule out
narrowing or inflammation of the
esophagus.
Treatment
of acid reflux in infants depends on the
severity of the problem. For most babies, the
symptoms disappear as the baby grows older. If the
symptoms are severe or if acid reflux is diagnosed
the doctor may prescribe over-the-counter
medications such as antacids, acid suppressors or
acid blockers. However, these medications have
side effects such as poor digestion, diarrhea,
bloating, decreased absorption of various
nutrients, increased risk of gastrointestinal
infections, electrolyte imbalance, increased risk
of rickets, and impaired kidney function.
Medications should be given only if necessary.
Making
some lifestyle changes will definitely help reduce
symptoms of acid reflux. But it is better to
consult a doctor before making any major changes
in sleeping positions, feeding
etc.
1)
Keep infant upright during feeding and for at
least 30 minutes after
feeding.
2)
At night, position the infant on his back and
elevate the head of the bed to 30 degrees.
3)
Smaller frequent feedings work best. Overfeeding
increases abdominal pressure and may lead to acid
reflux.
4)
Thickening the feeds with rice cereal is also
useful.
5)
Breast fed babies have fewer and lesser episodes
of acid reflux. Breast milk is more easily
digested than formula and less irritating to the
digestive tract. Breast-feeding mothers, however,
must avoid garlic, chocolate, caffeine and other
foods that may promote
reflux.
6)
Burp the infant several times during feedings.
This helps minimize gastric pressure and reflux.
Burping infant on a full stomach increases chances
of regurgitation.
7)
Avoid elastic or tight clothes around baby’s
waist.
8)
Avoid giving citrus juices and caffeinated
beverages to infants.
Generally,
these measures go a long way in not only relieving
the symptoms but preventing the condition from
becoming chronic as the infant grows older. Unlike
OTC drugs, they do not have side effects and can
be incorporated as lifestyle changes. But in
majority of cases, the infants outgrow the
spitting up or acid reflux by the time they reach
their first birthday.
