Infant GERD Symptoms

Infants occasionally spit up, but if your baby does it frequently she could have a form of heartburn called gastroesophageal reflux disease, or GERD, can make your first year with your child challenging. Depending on how severe it is, you could be spending a lot of time soothing your crying baby. She'll likely outgrow GERD, as most infants do, within her first year. The condition generally peaks around four months and starts to subside when babies begin eating solids and sitting upright.

Causes

• The flow of food and gastric juices from the stomach into the esophagus causes GERD. The valve that connects the stomach and esophagus, called the esophageal sphincter, normally tightens to prevent food and acids in the stomach from coming back into the esophagus. When the valve isn't fully developed or is weak, it loosens instead of tightening and allows the acidic stomach content to reenter and irritate the esophagus and throat. As your baby's esophageal sphincter grows stronger, symptoms should start to gradually disappear. GERD usually develops during a baby's first month and occurs more often in premature babies.

Symptoms

• Symptoms of GERD include inconsolable crying, frequent spitting up and excessive vomiting. Your baby might also react to abdominal pain by drawing his legs up, arching his back or waking up screaming. Other symptoms include excessive drooling, gagging or choking, frequent burping, difficulty swallowing and refusing to eat. Severe cases of GERD can result in choking spells, apnea, inadequate weight gain from not holding down enough food and respiratory problems such as pneumonia or sinus infections when liquid enters the lungs and nose. Call your pediatrician if you're concerned about your baby's weight or if he seems to be in severe pain.

Diagnosis

• Your pediatrician might diagnose GERD after an examination and description of your baby's symptoms, but further tests can be done if the doctor is unable to make a diagnosis right away. X-rays of the upper gastrointestinal area will allow the doctor to see damage. Your baby will have to swallow a chalky drink called barium in order for the damage to appear on the x-ray. A scope of the digestive tract provides additional information about your baby's condition. The doctor will take small tissue samples, or biopsies, and place a thin tube into your baby's nose that runs to the base of her esophagus. This PH-probe will be monitored for 24 hours.

Medical Treatment

• Mild cases of GERD often resolve on their own within months. GERD that causes severe pain can be treated with medications to ease your baby's discomfort while the condition runs its course. Your pediatrician could prescribe or recommend children's antacids or acid suppressors in low doses. These generally work and are usually taken for about one month. Prescription drugs that help the digestive system work more effectively at keeping food moving down can also lead to an improvement in your baby's condition. Surgery might be done to tighten the esophageal sphincter but this is generally performed only if other forms of treatment have been unsuccessful.

Home Care

• You can lessen the severity of your baby's reflux by continuing to breastfeed, since babies digest breast milk more quickly and easily than formula. However, you should eliminate caffeine, which can cause reflux, from your diet so that your baby won't ingest it when he drinks your breast milk. Feed your baby in a quiet and calm environment and make sure you burp him frequently. Do several smaller feedings throughout the day to avoid giving your baby too much at once. Keep your baby upright when he eats and for up to two hours after feedings. Offer your baby a pacifier after he eats since the sucking motion can ease reflux. Don't bathe or play with your baby right after he eats.