Infant reflux is a common problem. About half of all babies from birth to three months experience some symptoms of reflux, with symptoms peaking at age four months, according to "Archives of Pediatric and Adolescent Medicine." The good news is that most babies with reflux outgrow the problem within the first year of life, many within the first six months. Because some of the symptoms can be subtle, the diagnosis of infant reflux can sometimes be difficult to make early on.
Vomiting
The most common symptom of infant reflux is vomiting. This can range from mild spitting up or an occasional "wet burp" to projectile, forceful vomiting. Many times the vomiting occurs immediately after a feeding, when the stomach is most full, but at other times the vomiting may occur several hours after a feeding. Changes in position tend to trigger the vomiting, such as when an infant goes from being upright to lying down. The vomiting may look like breast milk or formula, curdled milk, or thin mucus. Vomiting of blood or bile is not typical of infant reflux ,and these symptoms should prompt immediate medical care because of the possibility of an underlying life-threatening intestinal condition.
Fussiness
When babies have frequent regurgitation, the esophagus can become irritated, causing pain. According to a 2009 article published in the "Journal of Pediatrics," even when esophageal erosion hasn't occurred yet, infant reflux can cause heartburn and tummy bloating. Although some babies with very mild infant reflux seem unaffected by the spitting up, babies with more severe reflux are often very fussy. Vomiting may appear to be painful, and simple things like taking a bottle or lying down flat can trigger babies with severe reflux to become unusually fussy. Sometimes, infant reflux is confused with colic, because both conditions cause crying and fussy behavior in babies.
Feeding Refusal
Because feeding triggers regurgitation in infants with reflux, some babies associate eating with pain and begin to refuse feedings. At other times, the reflux may be occurring during a feeding, and the baby pulls away from the breast or bottle, arches the back, or cries out in the middle of a feeding. Sometimes this difficulty with feedings becomes so severe that babies stop short of finishing their feedings and fail to gain weight appropriately. For this reason, it's important for babies to have regular checkups with a medical provider to make sure that they are staying on track with weight gain.
Cough and Wheezing
Occasionally, babies with infant reflux suffer from frequent, small, repeated episodes of choking, and they can actually have non-life-threatening aspiration of stomach contents. If these episodes occur frequently enough, the bronchial tubes can become irritated, causing the baby to cough and wheeze. Sometimes, infants with respiratory symptoms from reflux are misdiagnosed with asthma. Any baby with frequent and recurrent cough and wheezing should be evaluated for possible underlying gastroesophageal reflux.
References
- "Archives of Pediatric and Adolescent Medicine"; Prevalence of symptoms of gastroesophageal reflux during infancy. A pediatric practice-based survey. Pediatric Practice Research Group; SP Nelson et al; June 1997.
- "Journal of Pediatrics"; Multicenter, Double-blind, Randomized, Placebo-controlled Trial Assessing the Efficacy and Safety of Proton Pump Inhibitor Lansoprazole in Infants with Symptoms of Gastroesophageal Reflux Disease; S Orenstein et al; April 2009
