Gastroesophageal reflux in newborns and infants occurs when swallowed food from the stomach returns to the oesophagus, causing vomiting or leakage
THIS IS CAUSED BY POOR FUNCTIONING OF THE VALVE IN THE UPPER PART OF THE STOMACH, WHICH USUALLY STOPS THE PROCESS OF RETURNING THE FOOD CONTENT. IT AFFECTS HALF OF ALL CHILDREN UNDER THREE MONTHS. IT MAY APPEAR MANY TIMES A DAY, ESPECIALLY AFTER FEEDING.
Why do so many children get reflux?
When we swallow food, there are usually many physiological factors keeping it in the stomach.
- First, we usually sit down while eating food, so gravity helps keep food at a lower level.
- Secondly, we usually eat food of proper weight and density which is easier to keep in the stomach.
- Third, we have the lower oesophageal sphincter, which is a muscular band around the lower end of oesophagus to help stop food from coming back.
- Fourth, the oesophagus is quite long, adding to the distance food has to travel to return
These factors are absent in infants. Most of the time, they are lying down, consuming only fluids, not yet having well-developed muscles, and having a short oesophagus. As a result, children are much more likely to develop reflux.
Reflux is not necessarily a bad condition in children. If large amounts of milk have been consumed while nursing, acid reflux is the body’s way of relieving the discomfort of an overly full stomach.
What are the symptoms?
The most common symptom of reflux is a slight leakage of milk after feeding. Other symptoms may include restlessness or discomfort, crying during or after feeding, and more vomiting while feeding. Some babies may refuse to feed or vomit so much food that they are unable to gain weight. Some even lose weight. It’s important to note that many of these symptoms can be caused by health issues other than acid reflux, such as colic, bovine protein intolerance, infections, and gastrointestinal disorders.
How to relieve reflux symptoms?
Very few children (less than 5%) with acid reflux have continued symptoms until the age of one. The child’s weight should be monitored under the supervision of a paediatrician who will assess whether or not he is refluxing. It should be remembered that reflux symptoms subside over time and their frequency decreases as the gastrointestinal tract matures.
In relieving the symptoms of gastroesophageal reflux (e.g. esophagitis, dysphonia, regurgitation – the return of the stomach contents to the mouth) in infants and children, it is helpful to use anti-reflux syrup (containing magnesium alginate, simethicone and xanthan gum) with a mechanical protective effect to prevent regurgitation digestive content and pouring out the food. In addition, non-pharmacological treatments can be used. It involves placing the baby in the correct position on its back or placing it on its stomach with its upper body raised by 30-45 degrees under parental control. It is not recommended to leave the baby in a sitting position after eating. Additionally, it is recommended that a 1-2 week trial of hypoallergenic formula feeding be given to formula-fed infants who are vomiting/spitting. You can also try to thicken the milk mixtures with rice gruel, carob or potato starch.