If your child has acid reflux, or gastrointestinal/gastroesophageal reflux (GER), the symptoms can be bad enough. But because GER can cause sleep disorders, you've got the potential for one unhappy child. Luckily, there are a few things you can do at home to make things better.
What is GER?
GER, or acid reflux, is a physiological problem. It's quite common among babies, and includes familiar symptoms such as spitting up after a meal. Sometimes feeding the child too much contributes to spitting up, but often it's caused by an underdeveloped valve between the stomach and esophagus. This valve is meant to keep stomach contents in the stomach, but in babies it can malfunction. As long as your baby is only spitting up a few teaspoons or less, there's not much to worry about. Babies usually outgrow the problem in a few months.
In older children, overeating, obesity or sensitivity to certain foods can cause GER. Heartburn is a common symptom of GER in adults, but most children under 12 years old don't get heartburn. Instead they might have difficulty swallowing, a dry cough, or symptoms of asthma.
What is GERD?
GERD, or gastroesophageal reflux disease, is more serious than simple GER. Babies and children with GER are usually still happy and healthy, but those with GERD can experience more abdominal pain, nausea, choking or gagging, and other issues.
If your child is still experiencing symptoms of GER after his first birthday, then it could be GERD. If your baby isn't growing properly, refuses to eat, is irritable or arches his back like he's in pain during or immediately after eating, that could also be a sign of GERD. If not properly diagnosed, GERD can lead to other problems such as recurrent pneumonia, asthma, sinus congestion, wheezing or ongoing problems with sleep.
GER and Sleep
People who experience nighttime acid reflux, even without heartburn symptoms, have problems sleeping. GER symptoms get worse at night because of the horizontal position, and can cause the person to wake up when acid splashes up into the esophagus or throat. If no other symptoms are present, this is sometimes referred to as "silent reflux," and might be a root cause to many unexplained sleep disorders. If GER is causing problems breathing as well, that can further impede the ability to sleep.
People who have obstructive sleep apnea, or OSA, which causes them to stop breathing repeatedly during the night, also often have severe symptoms of GER. Three percent of children have apnea, and most of them are between 2 and 5 years old. Symptoms of OSA include snoring, breathing through the mouth, and difficulty breathing while sleeping.
In one study, patients with apnea reported a low quality of life, and those that also had nighttime GER said their quality of life was even worse. If your child has similar symptoms, then diagnosing and treating the reflux can improve his general well-being.
Treatments
The best first treatment for acid reflux is a lifestyle adjustment. Elevate the head of your child's bed, crib or bassinet so the contents of his stomach are less likely to come up while he's sleeping. To do this effectively, extra pillows won't help. The whole head of the bed should be raised on blocks that are 6 to 8 inches high.
Reducing reflux before he ever gets to bed is important, too. During feedings, burp your baby often, and have him sit upright for 30 minutes after eating. For older children, sitting or standing upright for two hours after eating is recommended.
For babies, try changing his feeding schedule, and always feed him upon awakening rather than before sleeping. Ask your baby's doctor if it's OK to thicken his bottle feedings with cereal or start introducing solid foods.
For older children, teach them to graze--eat more, smaller meals spread throughout the day--rather than consuming large meals. Encourage exercise, and limit medications, beverages and food that can cause reflux, such as fried or fatty foods, spicy food, acidic food like citrus fruits and tomato sauce, chocolate, mint, and caffeinated beverages.
Ask a Doctor
If home remedies don't fix the problem, or at least lessen the symptoms, talk to your child's doctor. It might be GERD, obstructive sleep apnea, or something more serious, and needs to be diagnosed properly before the best treatment can be prescribed.
