Infant reflux

Reflux may occur many times in a day. Infant reflux occurs when the stomach contents enter into the throat or backs up. It is also called as pediatric gastroesophageal reflux. In infants, this condition is rarely serious and not a serious health concern if the baby has normal and healthy growth. As your baby gets older, the frequency acid reflux decreases. It is considered unusual if the infant gets reflux after 18 months.

Causes and risk factors

The sphincter present between the esophagus and stomach is not fully matured, thus allowing the contents to flow backward towards the mouth.

The risk of acid reflux increases if babies have excess milk and are on a complete liquid diet or if they sleep flat on stomach most of the time.

Other conditions such as gastroesophageal reflux disease (GERD), pyloric stenosis, food intolerance, and eosinophilic esophagitis also cause infant reflux.

Symptoms

Due to reflux, your baby may have the following symptoms:

  • Unable to gain weight

  • Refuse to eat

  • Spit up green or yellow fluid

  • Excessive vomiting, worse after eating

  • A chronic cough, especially after eating

Complications

Usually, infant reflux resolves without causing any complications. However, if the underlying cause is GERD, your baby may have poor growth. Infants who spit up frequently are at increased risk for GERD.

Diagnosis

Your doctor begins diagnosis of infant reflux with a physical examination. Your doctor may ask you about the child’s symptoms. The diagnosis includes:

Ultrasound – to detect pyloric stenosis

Esophageal pH test – to monitor stomach contents coming backward to the esophagus

Blood and urine tests – to determine causes of vomiting and poor weight gain

X-ray – to detect abnormalities in the digestive tract

Upper endoscopy – to evaluate inner lining of the upper gastrointestinal tract (GI) using endoscope (small device that has camera and light and inserted into the upper GI)

In infants and children, this procedure is performed by administering anesthesia.

Management

In the case of bottle-fed infants, reflux can be controlled by modifying feeding schedule. You should take care of your infant by following certain measures:

  • Provide your baby smaller, more frequent feedings instead of larger feedings.

  • Make your baby burp regularly, at least one or two hours after feeding. This helps to relieve gastric pressure and prevent reflux.

  • Avoid overfeeding as the baby is more likely to develop reflux if the stomach is full. This is due to the reason that pressure on lower esophageal sphincter increases if your infant’s stomach is full making the contents move backward to the esophagus.

  • Hold your baby upright while feeding.

  • Check bottle and nipple size before feeding. Your baby may swallow air if the nipple on the bottle is small.

Your doctor may suggest repositioning surgery, which involves straightening the shaft of the penis. Surgery would be successful in the early age, usually between 3 to 18 months. The hypospadias repair surgery involves removal of tissue grafts from the foreskin of the penis and reconstructing the urinary channel in the normal position. Surgery would take 2 to 3 hours, and the condition may rarely require further procedures.