Acid reflux occurs commonly in babies. The muscle at the lower part of the esophagus -- the lower esophageal sphincter -- is designed to open to allow food into the stomach and tighten to keep foods and digestive acids in the stomach. The muscle often relaxes too much and allows partially digested food and gastric acids from the stomach to flow back up the esophagus. Acid reflux afflicts babies, children and adults. Babies 18 months and younger seem particularly vulnerable because their nervous and digestive systems are still developing. Home and medical treatments can improve symptoms of acid reflux.
Symptoms
Symptoms of normal acid reflux can include spitting up, coughing, vomiting, irritability, and blood in the stool. In more severe cases, babies can develop more adverse symptoms, including poor growth, refusal to eat because of pain, blood loss from stomach acids burning the esophagus and breathing problems. The website Family Doctor recommends you contact your pediatrician if symptoms include failure to gain weight, spitting up more than 1 or 2 tbsp. of milk, violent or forceful vomiting, decrease in wet diapers indicating dehydration, lethargy, excessive irritability or spitting up green or brown liquid. Reflux symptoms can escalate into gastroesophageal reflux disease, GERD, when reflux causes significant medical problems, such as apnea, asthma, low weight gain, sinus or ear infections or esophagitis.
Food Management
If you are breast feeding, the foods you eat will affect your baby, so you should modify your own diet if your breast-fed baby has acid reflux problems. If your bottle-fed baby has acid reflux, try thickening the formula with rice cereal. Add up to 1 tbsp. of cereal per 2 oz. of formula. Feed your baby smaller amounts more often rather than fewer, larger meals. Burp your child after every 1 or 2 oz. of formula or if you are breast-feeding, after feeding on each side.
Foods to Avoid
You can start to introduce solid foods to your baby at 4 to 6 months. Certain foods can trigger acid production and therefore should not be fed to babies on solid food and should be avoided by breast-feeding mothers. Vegetables such as cauliflower and cabbage and citrus fruits such as tangerines, pineapple and oranges can trigger acid. Tomato-based sauces, black pepper and spicy foods trigger acid, as do beverages or foods with caffeine such as coffee, tea, energy drinks and chocolate products such as chocolate bars, chocolate milk and cocoa.
Fatty, greasy or fried foods relax the lower esophageal sphincter. Avoid creamy sauces, margarine, butter, mayonnaise, chocolate and high-fat meats. Fruit juices and peppermint also relax the lower esophageal sphincter.
Foods That Help
Low-fat foods decrease acid production. Use low- or non-fat versions of dairy products such as skim milk and low-fat yogurt. Babies can start to eat meat at around 7 to 10 months of age. Avoid red meat, which contains more fat and instead serve fish, chicken or turkey. Certain fruits and vegetables neutralize stomach acid, including apples, grapes, bananas, peas, broccoli and green beans. Also, whole-grain cereals reduce stomach acid.
Fluids
Milk is a base and neutralizes acid. Water dilutes stomach acid. These fluids should be given between meals. Fluids during meals increase the volume of stomach contents and place pressure on the lower esophageal sphincter.
Medications
Your pediatrician can determine if medications should be prescribed. If so, she might prescribe medications that stop acid from flowing back into the esophagus, such as cimetidine, ranitidine, famotidine or nizatidine. Alternatively, the pediatrician might prescribe an antacid, such as esomeprazole, omeprazole, lansopazole rabeprazole or pantoprazole.
