Understanding Infant Reflux

Reflux occurs when stomach contents, like breast milk, returns from the stomach and travels up the oesophagus.

Babies tend to spend a lot of time on their back, so reflux is a lot more noticeable, and it is normal for all babies to experience some form of reflux on a daily basis. In most cases, the reflux is not a cause for concern, but it does require attention if the reflux interferes with the baby’s health, and quality of life.

Potential red flags include discomfort or weight loss, and this might be an indication of gastroesophageal reflux disease (GERD).

Symptoms of Infant Reflux

Occasional reflux is normal, and does not require a visit to the family doctor, but there are times when it is best to speak to your GP.

Contact your GP if your baby:

  • Is not gaining weight
  • Projectile vomits
  • Spits up green or yellow fluid
  • Spits up blood
  • Refuses to eat
  • Has blood in their stool
  • Struggles to breathe
  • Coughs chronically
  • Is unhappy after eating

What causes reflux?

Infant reflux is normally due to the lower oesophageal sphincter (LES) not being fully developed, and allowing the stomach contents to flow back up. This will recover with time. This is also made worse due to babies lying flat, consuming a liquid diet, and in cases where the baby was born prematurely.

More serious causes include:

  • GERD – High acid in the reflux can damage the lining of the oesophagus
  • Pyloric stenosis – A narrowing of the valve between the stomach and the small intestine
  • Food intolerance – Brought upon by the protein in cow’s milk
  • Eosinophilic oesophagitis – A build-up of eosinophil, damaging the lining of the oesophagus

Complications of reflux

Most babies outgrow infant reflux, and will make a full recovery.

More serious conditions, including GERD, may affect and even stunt growth, and they may develop GERD in later years.

Diagnosing Infant Reflux

Your GP will conduct a physical exam, ask questions about your baby’s symptoms, and where needed, refer you to a paediatrician.

Additional testing may be required, including:

  • An ultrasound to test for pyloric stenosis
  • Lab tests to identify causes of projectile vomiting
  • pH Monitoring of your baby’s oesophagus to test acidity
  • X-Rays to test for abnormalities in the digestive tract
  • An upper endoscopy to video possible causes

Treating infant reflux

Most babies can be treated with changes to diet, sleep positioning, using food thickeners, and waiting for them to outgrow their symptoms.

Medication may be used if the baby suffers from asthma, has poor weight gain, refuses to eat, or have an inflamed oesophagus.

Surgery is an extreme procedure that will tighten the oesophageal sphincter. This procedure is normally only required if the reflux interferes with growth or breathing.

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