Gastroesophageal Reflux, or GER, is very common during the first year of a child's life. It occurs when stomach acids regurgitate from the esophagus back into the mouth. Often referred to in infants as acid reflux, GER can cause a burning pain in the throat and heartburn. GER treatment depends on the severity of the symptoms and the age of the child.
Lifestyle Modifications
The first line of defense where reflux is concerned is lifestyle modifications that concentrating on the infant's diet and positioning. The National Institute of Diabetes and Digestive and Kidney Diseases recommends frequent burping during feedings, adding rice cereal to formula or breast milk in babies older than 4 months of age, and taking care not to overfeed by reducing the food amount but increasing the frequency of feedings. Parents should attempt to hold their infant upright for 30 minutes after feedings, as sitting can put pressure on the abdomen and lying down might aggravate reflux.
According to the North American Society for Pediatric Gastroenterology and Nutrition, parents of formula fed infants with GER should try hypoallergenic formulas on a two-week trial basis. This action can help rule out the chance that formula contents are causing the problem, and may in fact provide symptom relief.
Medications
A pediatrician may opt for medication when lifestyle remedies fail and the infant continues to have trouble eating and sleeping. The need for medication is also more likely if the infant does not show adequate height or weight gain.
Doctors often start with H2-blockers that come in child-friendly liquid form and keep acid from backing up into the esophagus. Well known H2-blockers include ranitidine and famotidine, marketed as Zantac and Pepcid, respectively. If these fail to alleviate symptoms, doctors will likely prescribe proton-pump inhibitors to block stomach acid production. Examples of proton-pump inhibitors include omeprazole and lansoprazole, marketed as Prilosec and Prevacid, respectively. The U.S. Food and Drug Administration has approved all of these drugs for infants, according to the pediatric information site Dr. Greene.com.
Surgery
Sometimes medications and lifestyle medications are not enough. In cases where infants fail to gain weight, have severe esophageal irritation or have GER-related respiratory problems like pneumonia, doctors may choose to perform a fundoplication surgery, according to Children's Hospital Boston. This laparoscopic procedure involves wrapping the top portion of the stomach around the esophagus to create a tight band. This band greatly hinders stomach acid from reentering the esophagus.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Gastroesophageal Reflux in Infants
- North American Society for Pediatric Gastroenterology and Nutrition: Reflux Clinical Practice Guidelines
- Dr. Greene.com: Gastroesophageal Reflux Treatment
- Children's Hospital Boston: Gastroesophageal Reflux (GERD)
