Gastroesophageal reflux is common in infants. According to the National Digestive Diseases Information Clearinghouse, more than half of all infants have reflux in the first three months of life but outgrow it by the time they are 1 to 2 years of age. Infants can exhibit several symptoms of gastroesophageal reflux, including dry heaving, which may require treatment.
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What Causes Reflux?
Gastroesophageal reflux results from weakness of the lower esophageal sphincter, the muscular band of tissue that prevents the stomach contents from flowing backwards. If the lower esophageal sphincter does not close properly, food and stomach acid can flow back into the esophagus and into the mouth or nose. This can happen around feeding time or even when the baby coughs or cries.
Dry heaving is a symptom of reflux. Other symptoms include vomiting milk, frequent spit-ups, crankiness or irritability around feeding time and refusal to feed. Some infants may have blood in the stool or when vomiting due to the esophageal inflammation. Some infants have worse symptoms, resulting in poor growth, breathing problems with cough or wheezing and anemia. Other infants may exhibit back arching as a result of the pain associated with reflux. This arching motion is often mistaken for a seizure. According to the Mayo Clinic, these symptoms are not exclusive to infants with reflux, so if your baby exhibits them, it is important to be evaluated by a physician.
Most infants with reflux respond to simple feeding maneuvers, such as offering small but frequent amounts of milk, holding the baby upright during and after feedings and burping frequently. If these techniques don’t work, medications may be appropriate. These include H-2 blockers, such as cimetidine or ranitidine, and proton pump inhibitors, such as omeprazole. These medicines work by decreasing the production of acid in the stomach.
If medicines do not work, other alternative treatments are available. Infants may need to be fed a higher calorie formula if they are not gaining weight, or they may even need a feeding tube. According to the Mayo Clinic, another potential treatment is surgery to tighten the lower esophageal sphincter. This procedure, called a Nissen fundoplication, is used in infants who have severe growth retardation or chronic breathing difficulty due to their esophageal reflux.