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 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. |
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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. |
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Symptoms?
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. |
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| Duration?
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. |
Diagnosis?
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. |
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Treatment?
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.
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Prevention?
• 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.)
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THE
FINAL WORD
• 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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