Acid reflux is a common name given to a condition called gastroesophageal reflux, or GER. Acid reflux in a newborn can be difficult to distinguish from regular spit-up. Monitoring the symptoms that accompany the spit-up can help a caregiver discern normal spit-up from GER. In many cases, treatment won't be necessary but there are many things a caregiver can do to help reduce the symptoms in an infant. Serious GER may require medication.
Function
Acid reflux is typically caused by the opening of the lower esophageal sphincter, a band of muscles that prevents stomach contents from flowing back up the chest. This band of muscles is weak in a newborn due to immaturity but it will strengthen over time. When the sphincter opens, the acidic stomach contents go back up the esophagus to the throat and mouth. The result can be vomiting or copious amounts of spit-up.
Causes
In addition to the lower esophageal sphincter being weak in an infant, other factors can contribute to acid reflux in a newborn. MayoClinic.com suggests that an air bubble in the esophagus can force liquid out of the baby's mouth. Eating too much or too fast can cause the stomach to be too full and overflow up the esophagus. An infant spends most of the day on his back, which can also encourage the reflux of stomach fluids.
Symptoms
Infants with acid reflux are likely to spit up at times other than just after a meal. Spit-up alone isn't a reliable indicator of acid reflux. Instead, caregivers should watch for signs of discomfort. A happy spitter, or a baby who spits up but doesn't seem to be impacted, isn't likely to have acid reflux. DrGreene.com suggests that normal spit-up isn't likely to be acid, which is why an infant can appear to be perfectly content despite all the spitting up.
GER can make a baby fussy and irritable during and after meals. The baby may even reject food to avoid discomfort. Other factors a caregiver can watch for include back arching, wheezing, hoarseness or apnea. Apnea is a temporary cessation of breathing that occurs when the body attempts to protect the lungs from the acid fluids entering.
Treatment and Prevention
Preventative measures are often recommended before medications, especially in mild reflux cases. Caregivers can evaluate the amount and type of food the infant is eating as a potential source of reflux. Overfeeding a baby can make reflux more likely. Some infants may have an allergy to milk formulas or the dairy products a breastfeeding mother consumes. The mother can keep a food log and do a dairy elimination diet for several days to see if her baby's reflux improves. If cow's milk formulas are suspected, caregivers should consult a doctor about trying a different formula, such as soy.
Other preventative measures include adding a bit of rice cereal to the baby's milk to make it harder to spit up, keeping baby upright after and during a meal and burping baby adequately after a meal.
Some medications, such as antacids and H2-receptor antagonists, may be recommended by a medical care professional, according to DrGreene.com. These medicines work by neutralizing acid or by decreasing acid production in the stomach. Another type of medication is a proton pump inhibitor, which blocks acid production but may not be suitable for newborns unless recommended by a doctor.
Complications
More serious cases of infant GER can interfere with the baby's overall well-being and growth. Any signs that an infant is losing weight or gaining at a less that adequate rate require medical intervention. Other signs of serious GER include fluids flying far from the infant's mouth, spitting up quantities of fluid larger than a tablespoon or two at one time, unusually colored spit up and signs of other illnesses, suggests MayoClinic.com. DrGreene.com points out that some of the illnesses that can occur because of serious reflux include pneumonia, wheezing or a chronic cough. Medical treatment, such as the use of prescription medications, will be recommended if ay complications exist.
