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Gastroesophageal Reflux

While all babies spit-up a bit, some regurgitate excessive amounts of milk, because of a condition called gastroesophageal reflux (GER). GE reflux or GER results from stomach acid rising up the esophagus through the inadequate closure of a valve between the baby's esophagus and stomach. The condition typically shows up within the baby's first few weeks and can last for several months. The many faces of reflux are evident in the following: a baby who spits up all the time. an adult with chronic heartburn, a child who won't gain weight, an unhappy toddler, an infant who cries and cries, continuous wheezing, recurrent coughing. Most parents will agree that GE reflux can be a nightmare, especially when it persists beyond the simple spit ups and babyhood.

Who gets it?

In most newborns up to 3 months of age, the lower esophageal sphincter or valve is relatively lax. Thus, frequent spitting up is common. Otherwise the baby is normal, happy, eats well, gains weight, and has no other symptoms. Still, this spitting up is often upsetting to parents. It can also be quite inconvenient in that parents frequently must change clothes -- theirs and the child's. With time, physiologic reflux as its termed, remedies itself when the valve becomes more competent; children eat more solid food; they assume a more upright posture; the spitting up diminishes.

The other version is more persistent in nature and is called pathologic reflux. About two-thirds of children with pathologic reflux have poor weight gain.


Symptoms might include poor weight gain, heartburn, vomiting irritability (especially after eating or while lying down) wheezing, chronic cough, pain with eating, and blood in the stools. A child might have any or all of these symptoms, but not actually spit up, if the stomach contents are re-swallowed.


In most cases, the spitting up resolves without treatment by about 18 months of age. If reflux persists beyond age 2, there is generally not much improvement until age 4. If the condition still exists when the child is closer to puberty, then the likelihood of having reflux as adults is high -- unless corrected.


When reflux lasts beyond about 18 months, or when it is associated with other symptoms at any age, it should be evaluated. Mention the possibility of GER to your doctor. If the infant is healthy, happy, and growing well, no tests or treatment may be needed. The diagnosis is usually made based on the history given by the parents.


Doctors won't jump to medical solutions as a means of treatment. They may recommend other ways, which might include changing feeding and posture habits or i f a child is not growing well, feedings with higher calorie content foods. Medical treatment for pathologic reflux is usually quite effective. Some medications can help speed the emptying of stomach contents into the intestine or lower the production of stomach acid. In severe cases an operation may be necessary. Discuss with your baby's paediatrician.


• Sometimes smaller, more frequent feedings will prevent reflux.

• Avoid overfeeding baby as it can aggravate reflux.

• Keep baby upright and quiet for at least thirty minutes after feeding.

• Wear your baby in a carrier as long as possible. Carried babies cry less. Babies reflux more while crying.

• Breastfeed. Studies show that GER is less in breastfed babies.

• If you are bottle-feeding (and if recommended by your doctor), thicken baby's feedings with rice cereal.

• Discuss with your doctor the safest sleeping position for your baby. Babies with severe reflux sleep best on their stomach and propped up at a 30-degree angle by elevating the head of the crib. (Babies without reflux should be put down to sleep on their backs.)


• GER occurs when stomach contents back up into the esophagus due to laxness in the lower valve.

• GER is common in infants but they grow out of it by 3 months of age or the problem resolves by itself before they turn two.

• In infant related GER, symptoms include spitting up, vomiting, coughing, poor feeding, or blood in the stools.

• Treatment depends on the infant's symptoms and age, and may include changes in eating and sleeping habits. Medication may also be an option, or surgery in severe cases.

Take heart! It's a temporary problem and there are always ways to mend this situation either through home remedies or with your pediatrician's help.

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Disclaimer: Information contained on this Web site is intended solely to make available general summarized information to the public. It should not be substituted for medical advice. It is your responsibility to consult with your pediatrician and/or health care provider before acting on any advice on this web site. While OEM endeavors to provide up-to-date and accurate information, it is not liable for any advice whatsoever rendered nor is it liable for the completeness or timeliness of any information on this site.
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