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Infant Reflux is Normal, but can be a Sign of Something More Serious
Reflux, or spitting up after feedings, is not uncommon and almost every baby experiences reflux of some degree. Tiffany Linville, M.D., pediatric gastroenterologist, says there are multiple factors that cause the varying degrees of reflux in babies.
“We know the connection between the esophagus and the stomach is immature in infants, which allows stomach contents to reflux more readily than in older children and adults,” Dr. Linville explains. “Secondly, because infants spend a larger portion of time lying down, their stomach does not always empty as well as it should.”
Though some regurgitation should be expected, if your baby shows extreme discomfort related to the reflux; if there is blood present in the baby’s spit up; if the baby has difficulty gaining weight; or gets lung infections or pneumonia, then the reflux could be a sign of gastroesophageal reflux disease (GERD).
If any of these issues arise, it is best to see a pediatrician to determine if an appointment with a pediatric gastroenterologist is appropriate. In severe cases, GERD can cause damage to the lining of the esophagus.
Dr. Linville says diagnosing reflux or GERD is typically done based on a thorough history from parents, as well as a physical exam in the gastroenterologist’s office. Sometimes, more invasive testing is required. “On occasion, the physician may think your baby needs an ultrasound or a barium study— known as an upper GI series,” she says. “These tests ensure that there isn’t an anatomic issue that is causing your baby’s vomiting. Another test that is sometimes ordered is a pH probe, which tests how much acid is being refluxed into the esophagus—this is usually done if a baby is not responding to medication. An upper endoscopy ensures that there aren’t consequences to the reflux.”
“Parents should know that some reflux or spit up is expected, ” says podiatrist, Dr. Linville. “Most infants’ reflux worsens until 4-6 months of age, and naturally improves thereafter. If a baby doesn’t have complications from reflux, then medications and treatment can be avoided.”
Treatment varies depending on the severity of the reflux, Dr. Linville says. “Medications often work very well,” she says. “For those with GERD, we use medications known as H-2 blockers or proton pump inhibitors. Also, different formulas have been shown to improve reflux symptoms in some infants. We typically do one thing at a time—change formula or prescribe medication—as we attempt to treat the symptoms.
It is not unusual for babies to continue to have spit up episodes or vomiting. If the baby has signs of GERD, more aggressive therapy will be considered.” Dr. Linville says about 80 percent of infants outgrow their reflux by their first birthday, and an additional 10 percent improve by year two.
“Parents should know that some reflux or spit up is expected,” Dr. Linville says. “Most infants’ reflux worsens until 4-6 months of age, and naturally improves thereafter. If a baby doesn’t have complications from reflux, then medications and treatment can be avoided.”
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