While gastroesophageal reflux disease brings to mind a condition that affects adolescents and adults, GERD can also affect infants. Infants have different symptoms due to GERD and it may be difficult to identify the disease in some cases. In many cases, infants may regurgitate their food. Mothers should consider breastfeeding their infants with GERD, because this is less likely to aggravate the condition. In some cases, use of antacid medications may be needed to manage the condition.
Cause of GERD
When your baby swallows food normally, it enters the stomach via the esophagus. To prevent food from going backward, the lower end of the esophagus is usually kept closed at all times, except during swallowing. In some infants, this closure may be incomplete, which can allow the highly acidic gastric juice to go upward and cause symptoms. In infants, there may be a condition in which the lower esophagus dilates in response to a full stomach, a phenomenon known as transient lower esophageal sphincter relaxation.
GERD in Infants
Symptoms of GERD in infants are often different from the typical symptoms of GERD experienced by adults and adolescents. Infant reflux is most common in the first few months of life. It is worst at four months and usually resolves after the infant's first birthday. Affected infants often regurgitate following feeding. Infants may be irritable, and have back arching movements, choking and gagging. Some infants develop an aversion to food for these reasons and may fail to gain weight as a result.
Role of Breastfeeding in GERD
Breastmilk has been shown to cause relief of GERD symptoms. A study published in 2009 in the journal "Pediatrics" found that exclusively breastfed babies had a lower incidence of GERD than infants who were partially breastfed or not breastfed at all. A similar finding was found in another study published in "Acta Pediatrica," which found that infants with GERD had faster relief of symptoms when they were breastfed. Though the reasons for this are unclear, it may be due to the easy digestibility of breast milk, allowing it to leave the stomach quickly and enter the lower intestinal tract.
Other Treatments for GERD
A variety of other treatments also play an important role in treating GERD in infants. Positional measures are an important mode of treatment. Infants who are feeding should be kept upright while feeding; this allows gravity to prevent food from going upward. Raise your baby's bed slightly to keep his head elevated while sleeping. Settling the infant to sleep on his stomach has been found to reduce GERD; however this is not recommended because it can increase the risk of sudden infant death syndrome. If symptoms don't improve with these measures, your doctor may prescribe medications in the form of H2 blockers or proton-pump-inhibitors.
References
- "Nelson Textbook of Pediatrics, 18th Edition"; Robert M. Kliegman, et al.; 2008
- "Acta Paediatrica"; Natural Evolution of Regurgitation in Healthy Infants; B. Hegar, et al.; July 2009
- "Pediatrics"; Prevalence and Natural History of Gastroesophageal Reflux: Pediatric Prospective Survey; Angelo Campanozzi, et al.; March 2009
- MayoClinic.com; Infant Acid Reflux; August 2011
