baby

Reflux: is it just spit up or something more?

baby1-1-10.jpg

Gastroesophogeal reflux is common in infants.  It can be a major cause of crying, poor feeding, and sleep problems. 

 

 

There are two types of reflux:

 

 

 

GER: Gastroesophogeal Reflux

 

 

GERD: Gastroesophogeal Reflux Disease

 

 

 

Here’s the difference:

 

GER refers to normal spitting up that all babies do.  The stomach contents flow up into the esophogus and out in the form of “spit up”.  Every new parent walks around with it on their shirt, in their hair, and smells it on their sheets as they fall asleep.  It’s everywhere for the first few months of your life with the new bub.  Totally normal.  This kind of reflux is caused by an immature LES (lower esophogeal sphincter) that gradually gets stronger as baby grows. Therefore, the older the baby, the less he should be spitting up.  GER is nothing to be concerned about, and shouldn’t interfere with baby’s overall contentment.  Sure, they may fuss before a burp and then feel ahhh, relief upon getting it out, but all of that is just feeding related and totally normal. 

 

 

GERD, on the other hand, is a more serious form of GER that requires a diagnosis by your pediatrician or specialist.  It is basically GER that lasts too long or becomes more severe than just normal spitting up.  If your kid has it, you might know, but you might not.  You will most likely be pacing around and have moments of wanting to flee the home after trying to calm your fussy baby  for hours.  (remember, there is help for those times….email us for info).  GERD can be extremely uncomfortable for a newbie.  The fluid that regurgitates up through the esophogus is highly acidic and burns.  Here’s what makes it hard to diagnose though: babies with GERD do not always spit up.  The stomach juices may make it all the way up into the throat but then bubble back down again.  Ouch.  This is called silent reflux.  Hence, a crying baby who can’t even give mom and dad a visible sign of what’s wrong.

 

 

 

How can you tell if your baby has GERD?

 

Here are some clues that you might have a refluxy baby on your hands:

 

  • Long periods of crying

 

  • Throwing up a lot

 

  • Persistent cough

 

  • Difficulty eating/ crying with feeding

 

  • Excessive gas

 

 

 

What can you do to manage reflux?

 

 

Feed your baby upright or at an angle

 

 

A bouncy seat or car seat works well for infants not yet able to sit up.  You can also prop up pillows under your arm while holding baby to achieve this angle. Gravity works to keep the fluid down.  Keep baby upright for at least 30 minutes after feeds to assist with digestion.

 

 

Feed baby small amounts

 

There’s nothing worse for reflux than an oversized feeding. Think mini-meals: stick with small, frequent feedings throughout the day.  If that means breastfeeding every 2 hours rather than 3, it’s worth doing. 

 

 

Breastfeed

 

Breastmilk really is best, especially for a baby with reflux.  This is due to the enhanced digestibility of the proteins in human milk vs. cows milk.  The intestinal flora of babies exclusively fed breastmilk is different from that of formula fed babies.  To read more about this: http://drjaygordon.com/pediatricks/startingout/supplement.html

Massage your baby

 

How does it work?  One: it relaxes baby.  Reflux is tied in with the stress response from the sympathetic nervous system, which involves a whole lot of cortisol swimming around.  Massage helps to lower the stress response and coritsol production and thereby reduces reflux.  Two: it stimulates the vagus nerve, which controls respiration and digestion.  The vagus nerve is interconnected with muscles around the esophogeal sphincter and the theory is that when the nerve is stimulated, these muscles contract better and keep stomach contents where they belong. 

 

 

Eliminate offending foods

 

If you’re breastfeeding, your diet may be irritating baby’s gut…. but it’s hard to know until you begin eliminating things.

 

 

 

baby1-1-9.jpg

What are the most common offenders?

 

  • Dairy

 

  • Wheat

 

  • Soy

 

  • Eggs

 

 

 

 

 

 

Probiotics

 

The jury is still out on whether probiotics help improve digestive function, but many hospitals are administering them to premature babies at risk for gastrointestinal infections.  Some studies have shown a positive affect among colicky babies, so it seems like they are worth a try.

 

 

 

Aloe Vera juice

 

baby1-3-2.jpg

Aloe vera works by coating and soothing the digestive tract.  It’s often recommend to adults with reflux, and can similarly benefit infants in smaller doses.  Be sure to check with your primary care provider or naturopath before administering any medicine or supplements. 

 

Medication

 

 

Your pediatrician may prescribe a proton pump inhibitor for your baby’s reflux if other interventions aren’t working that well.  These meds should be a last resort to consider only when the reflux is severe and literally nothing else is helping.  Why?  They have side effects, they aren’t necessarily that safe, and they don’t work that well.  The University of Michigan recently release an article on the overmedication of infants with reflux.  They explain how reflux is a common condition that most infants outgrow and doesn’t necessarily need pharmaceutical intervention. 

 

 

 

Sources: 

http://www.webmd.com/heartburn-gerd/reflux-infants-children

http://digestive.niddk.nih.gov/ddiseases/pubs/gerdinfant

http://www.mommyser.com/myblog/10-natural-remedies-infant-reflux

http://www.uofmhealth.org/news/archive/201304/over-diagnosis-reflux-infants-leads-needless-medication-0

 

 

http://abcnews.go.com/Health/babies-receive-acid-reflux-meds-doc/story?id=14926271