Infantile acid reflux (A.R.) is caused by the sphincter muscle's inability to close completely during digestion, thus allowing the acid to be regurgitated. This happens when the sphincter is immature, such as when a baby is premature, and generally will correct itself without medication by the child's first or second birthday; often times much sooner. Some babies are still happy and healthy, regardless of their problem, and no action is usually needed. However, it is when refluxing interferes with weight gain or physical discomfort that medication or other treatments may deem necessary.
When my daughter developed A.R. at 3 weeks of age, I was horrifiedI couldn't imagine such a small baby having such an uncomfortable and persistent problem. Her pediatrician then assured me of how common it is for babies to suffer from acid reflux. More infants today are being diagnosed with A.R. because doctors have discovered in several cases that what was once thought of as just colic was indeed A.R.similar to that of what adults develop, with paralleling treatments.
With my daughter, it finally got to the point where she was screaming after spitting up excessively, and gagging, before I informed the pediatrician. She was evaluated that same day. Her initial concern was to check for pyloric stenosis, (narrowing of the pylorus) and to see if her weight had decreased. That done, the pediatrician explained the symptoms and treatments of acid reflux and colic, as their symptoms are similar.
Symptoms include:
Excessive spit up
Coughing or gagging during or after feeding
Excessive hiccupping
Raspy-sounding breathing
Crying for no apparent reason
Disturbed sleeping patterns
Arching back while feeding
Difficulty burping or excessive gas
Treatments vary, according to each child. The most extreme measure would be to perform surgery, if warranted by any sort of physical abnormality causing A.R.
Treatments include:
Medicine
Keeping baby upright for 30 minutes to an hour after feeding
Keeping baby semi upright to sleep
Feeding less per feeding more frequently
Adding cereal to bottles
Burp more frequently during feedings
Medicines are prescribed on a trial basis, as some babies do not respond well to the medication, and may need them to be switched occasionally. There are two types of medicines: H2 blockers, or Proton pump inhibitors. H2 blockers cut down on the amount of acid released from the stomach. Such medicines include Zantac, Pepsid, Tagamet, or Axid. Proton pump inhibitors, another way acid is controlled, include medicines such as Prilosec, Prevacid, Aciphex, or Nexium. However, this second group of medicines are not necessarily warranted for usage for children under the age of 2, as no tests for that age group have been done. While some babies will only need medication once a day, for only a few short months, others need it twice a day, for up to a year.
Keeping a baby upright during meals and for sleeping not only makes sense in preventing or cutting down on reflux, it also makes him or her more comfortable. Many parents do this by having the baby sleep in a car seat, bouncer, or baby chair, because of the semi-upright positioning. You may also prop the crib mattress to a 40 degree angle, making sure to secure baby with straps you can find in stores, or by using baby support pillows, to keep baby from tumbling.
Adding cereal to bottles is controversial, putting a child under the age of 4 months at risk for food allergies, obesity, or diabetes later in life, but it is not completely agreed upon across the board. Therefore, discuss it with your pediatrician beforehand. Contrary to former beliefs, cereal does not make a baby sleep longer, it simply makes them more "full" and unable to drink as much in a meal. Having the cereal is intended to make the liquid thicker, and less likely to reflux. You may purchase rice cereal, adding it as 1 tsp. per oz., with regular formula/breast milk, or purchase formula with the cereal already added to it (such as Enfamil's A.R.).
Overall, reflux is in many ways like having a "spitty" babyif your child is healthy, still gaining weight and having enough to eat, then you mostly have the problem of having to frequently wash clothes!