Saturday, February 27, 2010

Infant reflux

A topic near and dear to my heart!!! (I could probably write for a week on this subject..)

Infant reflux is very common. Most babies have it to a certain degree.

And the good news is most of them outgrow it!

What is Gastroesophageal reflux?
When a baby drinks their breastmilk or formula, the milk goes down the esophagus into the stomach through a valve called the lower esophageal spinchter. (LES) The job of the LES is to prevent food from coming back out of the stomach into the esophagus. In some babies, especially small ones, the LES is looser and doesn't work as well. And stomach contents come back up into the esophagus.

Who is more likely to get reflux?
Preemies, small babies.

What are symptoms of reflux?
Spitting, vomiting, crying with feeding, arching and crying with feedings. Babies can't complain of heartburn like adults can but they often cry in pain after eating.

What do I do about reflux?
Be patient, your baby will outgrow it! As long as your baby is gaining weight and doing well otherwise, they will usually outgrow it between 12-18 months. Once the baby spends more time upright and has more solid foods, the problem will get better and in most cases, go away completely.

In the mean time, there are a lot of things you can do.
Start by feeding your baby in a more upright position.
Hold the baby upright for at least 30 min after feedings (a bouncy seat works well for this).
Burp the baby frequently
Try not to jostle your baby too much immediately after feeding her.

If you have tried these things and you are still having trouble then talk to your baby's health care provider.

Sometimes switching formulas, adding rice cereal to formula or medications can be helpful. There are several medications that are used to treat infant reflux such as reglan, zantac, prilosec, prevacid, axid and antacids. They are all very commonly used and very safe. They are commonly used for a few months until the baby gets bigger then they are gradually stopped. My own kids were all on reflux meds.

In very severe cases reflux can cause apnea (periods of not breathing) and in these cases surgery may be suggested. These babies should be followed by a pediatric gastroenterologist.

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