Gastroesophageal reflux happens in more than half of infants during the first few months. Small amounts of food leak back into the esophagus from the stomach and cause your infant to spit up. Persistent reflux with vomiting can cause complications and an inability to thrive. Secondary breathing difficulty may arise if frequent vomiting allows stomach contents to enter your infant's airways. Severe symptoms require medical attention.
A ring of muscle between your esophagus and stomach relaxes to allow food intake, then closes tightly. This tight little muscle, or sphincter, keeps your stomach contents contained. In infants the sphincter may not have matured yet, which allows food contents to flow back up into the esophagus. It occurs most often after feeding, but can happen when your infant cries, coughs or strains.
Wheezing, as defined by the U.S. National Library of Medicine, is the sound made when air is forced through swollen bronchi during breathing. The result is a high-pitched whistling noise. The swollen, narrowed air passageways of infants can be caused by infections, asthma, allergies, smoke and gastroesophageal reflux disease.
Reflux and Wheezing
Symptoms of infant reflux can be complicated. Your infant may cough and spit up often, wheeze during breathing or exhibit persistent irritability. Many of the symptoms appear most often after feeding. Wheezing due to reflux is proposed to be caused by either microaspiration of gastric contents into the lungs, or spasms caused by an esophagus-trachea reflex. In a "Gut" 2001 publication by B. Avidan, done at the Department of Veterans Affairs Medical Center, 48 percent of patients studied had wheezing associated with acid reflux.
After proper diagnosis by medical professionals, infant acid reflux with wheezing can be treated naturally or with drugs. If your infant continues to gain weight and episodes of irritability are intermittent, the conditions will likely resolve as your baby gets older. More frequent feeding and burping help reflux, as well as thickening milk with cereal and holding the infant upright for 30 minutes after feeding. If your infant is continually uncomfortable, medications such as Tagament and Zantac can be prescribed. Rarely, surgery is required.
Untreated infant reflux with wheezing may result in certain complications. If your infant inhales during vomiting, stomach contents inhaled into the lungs can cause pneumonia. Constant irritation and swelling of the esophagus may cause scarring, which narrows the esophagus, making it difficult to eat. When using medications, some side effects may occur. Medications should be closely monitored by a gastroenterologist.
- National Institutes of Health; Gastroesophageal Reflux in Infants; Neil Kaneshiro; August 2009
- "American Family Physician;" Gastroesophageal Reflux in Infants and Children; Andrew Jung; December 2001
- National Institutes of Health; Wheezing; David Zieve, David Eltz; June 2010
- "Gut;" Temporal Associations Between Coughing or Wheezing and Acid Reflux in Asthmatics; B. Avidan, et al.; 2001