How Common Is Acid Reflux To Babies?

An estimate of 40 to 60 percent of newborns experiences some degree of baby acid reflux for the first few months because of an undeveloped lower esophagus sphincter (LES). Thus, it causes discomfort to babies due to the irritation of stomach’s hydrochloric acid in the esophagus. In addition, babies that face developmental or neurological difficulties are even more at risk from this condition. Yes it is true that most infants may outgrow this condition and may not require medical intervention but there is a percentage that they may not outgrow it and can lead to serious complications.

It is coined as Idiopathic or in layman’s term, the cause is unknown. Somehow, most Doctors believed that it is may be associated with an immature digestive system, hereditary factors, food sensitivities, and other medical issues which results in weakening of the valve between the stomach and the esophagus/oesophagus.

Anatomy and Physiology

The esophagus is the tube like structure that connects the mouth to the stomach. At the point where the esophagus joins the stomach, the esophagus is kept closed by a specialized muscle called the lower esophageal sphincter (LES). This muscle is important because the pressure of the stomach is normally higher than that in the esophagus. The muscle of the LES relaxes after swallowing to allow passage of food into the stomach, but then it quickly closes again.

GERD and acid reflux (GER)

Acid reflux (gastro-esophageal/oesophageal reflux GER/GOR) is most of the time perplexed with GERD or Gastroesopaphageal reflux disease. Baby acid reflux is not the same with GERD because GERD is a serious medical condition that requires medications such as antacids and a reconstructive surgery such as Nissen fundoplication and pyloroplasty. Gastroesophageal reflux disease (GERD) may be present without any manifestation of regurgitation just like acid reflux and needs to be treated.

What is reflux?

It is the backflow of stomach contents into the esophagus commonly called reflux due to weak lower esophageal sphincter (the ring like muscle at the lower end of the esophagus) between the esophagus and the stomach that does not properly open and close. It is commonly manifested as regurgitation (spitting up or vomiting) in babies and not essentially a cause for concern.It mostly likely occurs in neonates and diminishes at 6 months and disappears by 1 year. Acid reflux in babies can be a frustrating and painful condition. Successful management can be achieved through a variety of medical means and changes in the home.

Symptoms of acid reflux

  • Frequent spitting up or gulping with a painful look on the face
  • Projectile vomit, sometimes out the nose
  • Sour breath
  • Persistent hiccups or cough
  • Excessive and sudden burst of painful crying or colic
  • Sleep interruptions
  • Poor feeding habits – arches back, pulls up legs, stiffens or screams while feeding or refuses to eat while still hungry
  • Prefers upright or inclined positions
  • Always wants to be held

Other infant acid reflux symptoms that require a visit to the doctor includes:

  • Anemia
  • Bad breath
  • Colic symptoms seen with reflux
  • Damage to dental enamel
  • Difficulty swallowing
  • Ear infections
  • Eating constantly
  • Excessive drooling
  • Hoarseness
  • Neck arching after eating
  • Poor sleep habits
  • Refusing to eat
  • Sinus infections or congestion
  • Unusual fatigue
  • Weight loss
  • Sleep apnea

If present, your baby may have gastro-esophageal reflux complications. It is important to have an appointment with your baby’s pediatrician or child health nurse.

Diagnosis

The doctor can tell if your child has reflux based on the child’s health history and by examining your child. If vomiting or regurgitation is the only symptom of reflux, then further tests are not necessary. Special tests like x-rays (Barium Meal), nuclear scan, endoscopy and oesophageal pH study may be required if the doctor thinks there might be complications from your baby’s condition.

Acid reflux treatment

If otherwise healthy, your child does not need any special treatment. In fact, most remedies prescribed for such infants do not work. Uncomplicated regurgitation in babies usually resolves itself by 12 – 18 months of age.

Management of acid reflux

These are easy ways to manage infant acid reflux at home that can be done by the parent or guardian.

  • Elevate the head of the baby’s cot or bassinet
  • Hold the baby upright for 30 minutes after a feeding
  • Thicken bottle feedings with cereal (do not do this without a doctor’s supervision)
  • Change feeding schedules (discuss with the baby’s doctor first)
  • Try solid food (discuss with the baby’s doctor first)
  • Avoid lifting the legs too high, and turn to the side if possible
  • Refrain from overfeeding – if the baby vomits, do not resume rather, wait for the next feeding
  • If breastfeeding, avoid foods that aggravates reflux (citrus, tomato, fatty foods, spicy foods, chocolate and carbonated drinks)
  • If complications are present, consult your doctor and/or paediatrician.for advice.Some medications or a change in diet may be needed.

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