The Mayo Clinic website explains that infant acid reflux, more accurately known as gastroesophageal reflux disease, or GERD, is a very common problem that typically resolves on its own around 12 to 18 months of age. Infant acid reflux occurs when the contents of the stomach go back up into the esophagus, usually because of an immature lower esophageal sphincter muscle. The Kids Health website states that GERD can cause vomiting and fussiness in infants after feeding. Other symptoms include coughing, wheezing, refusing to eat and crying when the baby is placed on his back, especially after a feeding. Problems related to infant reflux can range from an uncomfortable baby to poor weight gain.
With a pediatrician's permission, most 5-month-old babies can have infant rice cereal added to their bottle. Ask your doctor how much cereal to add. The rice cereal will thicken the baby formula or pumped breast milk. When the liquid is thicker, it will sit heavier in the baby's stomach, helping to reduce reflux. You usually will need to buy a bottle nipple with a fast flow or cut the hole to be a bit larger, so that the thicker liquid can flow through easily.
When you feed your baby, keep her in an upright position for at least 15 minutes after she eats. Upright positioning allows gravity to reduce stomach back-flow. Try smaller, more frequent feedings. For example, if your baby normally eats 8 ounces every three hours, try changing her feeding schedule to 4 ounces every one and a half hours to allow the food to digest. Burp your baby thoroughly after each feeding. Less air in the stomach reduces reflux.
Histamine H2-Receptor Antagonists
According to the Infant Reflux website, Histamine H2-receptor antagonists, or H2-blockers, which go by the names Cimedine (or brand name Tagamet) and Ranitidine (Zantac), may be prescribed for GERD. These medicines block H2 histamine from receptors in the stomach, which reduces the production of acid. Side effects can include headache and dizziness in your baby. Because of these side effects, it is best to try natural remedies such as positioning techniques before resorting to medication.
Proton Pump Inhibitors
Proton pump inhibitors, or PPIs, can be prescribed to reduce infant reflux. PPIs go by the names Omeprazole (Prilosec) and Lansoprazole (Prevacid) and work by inhibiting the production of stomach acid. The Infant Reflux website states that rare side effects from PPIs include an allergic reaction, headache, stomach pain and diarrhea. According to the Mayo Clinic website, prolonged use of proton pump inhibitors has been linked to an increased risk of fractures of the hip, wrist and spine in adults.
Prokinetic agents include the names Metoclopramide (Reglan) and Cisapride (Propulsid). As of 2011, Propulsid no longer is available in the U.S. The Infant Reflux website explains prokinetic agents work by making the valve between the stomach and the esophagus shut tighter. They also make the contents of the stomach empty more quickly. Side effects can include nausea, diarrhea, nervous system side effects, drowsiness and restlessness.
Doses of medication and the amount of rice cereal given will vary based on your baby's weight, so the exact amount needed for a 5-month-old also will vary. The medications listed are prescription only and should never be given without a prescription and dosing instructions from a pediatrician. Talk to your baby's doctor before diagnosing your baby with or treating your baby for reflux.
- Kids Health: Gastroesophageal Reflux
- "Colic Solved: The Essential Guide to Infant Reflux and the Care of Your Crying, Difficult-to- Soothe Baby"; Bryan Vartabedian; 2007