Both food allergies and gastroesophageal reflux disease, GERD, are common problems that occur in infants following eating. Allergies are caused by specific foods that stimulate a child's immune system while GERD is due to the backward movement of food from the stomach to the esophagus. The treatment for each condition varies. Food allergies are treated by avoiding the food in question, and GERD is addressed by positioning and feeding changes. Fortunately, both conditions tend to subside on their own.
Food Allergies
Food allergies in infants are usually caused by exposure to specific foods. The infant intestine is unique in that it is able to absorb whole proteins into the circulation. This capability allows a baby to absorb antibodies in her mother's breast milk, protecting against infection. However, some other proteins also can be absorbed in this way and cause a reaction in the infant's immune system. This can lead to a widespread allergic response.
Symptoms of Allergies
Allergic reactions to soy and milk products are common. Symptoms include irritability, vomiting, and spitting-up. Diarrhea and poor weight gain also can occur. Eczema or hives might appear on the baby's skin. In severe cases, allergic infants can have an anaphylactic reaction, marked by difficulty breathing, wheezing and heart rhythm disturbances.
Treatment and Prevention
When weaning infants from breast milk, mothers should start foods one at a time to identify any possible allergic reaction. Each food should be given for three to four days to ensure that no reaction occurs. Giving foods in this manner helps identify any possible food allergies. The most important treatment is to avoid the food in question. In some cases, doctors prescribe an epinephrine pen that parents can use on their child in the event of a severe reaction. Many infants outgrow food allergies over several months.
GERD
GERD is caused by a weakness of the lower end of the esophagus. This is normally closed, but if there is incomplete closure, then highly irritating gastric juice and food can travel backward into the esophagus. According to "Nelson's Pediatrics," GERD in infants starts in the first few months of life, peaks at 4 months and generally subsides by a baby's first birthday.
Symptoms of GERD
The most common symptom in infants is food regurgitation, especially after eating. In addition, affected infants might be irritable, arch their backs, choke and gag. Infants might display food aversion and lose weight. Unlike food allergies, there are no skin or respiratory symptoms with GERD.
Treatment of GERD
A thorough medical history and examination usually can make the diagnosis, though a contrast X-ray might be needed in some cases. Use of thickened formula can help. Keeping the infant on her belly while awake can reduce GERD; however a sleeping infant should be placed on her back to prevent sudden infant death syndrome, SIDS. Medications doctors might use to treat GERD include antacids, antihistamines and proton-pump inhibitors.
References
- MedlinePlus: Food Allergy
- "Nelson Textbook of Pediatrics, 18th Edition"; Dr. Robert M. Kliegman, et al.; 2008
