Ask any parent what troublesome events you might face during your first years as a rookie parent, and spit-up and ear infections will probably make the top 10 list. These two conditions are often normal, but if your toddler vomits or spits up frequently and has ear infections on a regular basis, you may want to ask your pediatrician if acid reflux is to blame. Although the exact relationship isn't completely clear yet, acid reflux seems to play a role in causing some ear infections in toddlers and babies.
The Facts
A fairly common problem in babies, acid reflux occurs when stomach juices and acids flow back into the esophagus, typically producing a burning sensation in the chest and a sour-tasting liquid at the top of your baby's throat. Although the condition often remains mild and improves on its own as infants mature into their toddler years, acid reflux may worsen into more severe forms of reflux known as gastroesophageal reflux disease, or GERD, and extraesophageal reflux disease, or EORD. Possible signs of acid reflux disease in toddlers may include projectile vomiting, wheezing or coughing, sudden and unexplained screaming fits, arching of the back, lack of weight gain and irritability or refusal to eat at mealtime.
Considerations
Repeated ear infections may be a sign of acid reflux disease in toddlers and babies, says Dr. Thane Blinman, pediatric surgeon at Children's Hospital of Philadelphia and contributing author in "Fundamentals of Pediatric Surgery." When the reflux occurs, the contents of your toddler's stomach travel up the esophagus and may end up in your child's nasopharyngeal cavity, depending upon the severity of the condition. This nasopharyngeal cavity connects to your toddler's middle ears through thin, elongated passages called the Eustachian tubes. Irritation of the nasopharyngeal tissue may lead to inflammation of these tubes, which could swell shut and cause fluid to build up in the middle ear, thus leading to an ear infection.
Studies
Acid reflux may increase children's risk of suffering from middle ear infections, according to a study published in the July 2008 issue of the peer-reviewed journal "Laryngoscope." A team of researchers from Dupont Hospital for Children, led by Dr. Robert O'Reilly, examined the ears of more than 500 pediatric patients in an attempt to determine the role of acid reflux in producing middle ear infections. According to study results, 20 percent of participants with ear infections had pepsin -- a digestive enzyme produced in the stomach -- present in their middle ears, which indicates that they also suffered from severe acid reflux. Only 1.4 percent of the study participants without ear infections had pepsin in their middle ears.
Diagnosis and Treatment
Severe acid reflux disease could lead to serious respiratory problems in young children, so talk to your pediatrician if your baby has repeated ear infections in combination with any symptoms of acid reflux disease. Signs of a middle ear infection vary by child and may include excessive irritability and fussiness, tugging at the ear, an earache, ear drainage and fever. Treatment options for acid reflux disease vary depending upon the severity of the acid reflux and may include medication, surgery or lifestyle changes, such as feeding your baby smaller amounts more frequently or in an upright position.
References
- MayoClinic.com: Infant Acid Reflux
- "Pediatric Nutrition in Practice"; Dr. Berthold Koletzko, et al.; 2008
- "Fundamentals of Pediatric Surgery"; Dr. Thane Blinman, et al; 2011
- "Laryngoscope"; The Role of Extraesophageal Reflux in Otitis Media in Infants and Children"; Dr. Robert O' Reilly, et al.;July 2008
- National Institute on Deafness and Other Communication Disorders: Ear Infections in Children
