Gastroesophageal reflux is often simply called ‘reflux.’ It is medical term for the spitting up. It occurs when stomach contents reflux or back up into the food pipe (esophagus), these contents are sometimes regurgitated or vomited out of the mouth. See image courtesy medicine.net
Reflux is a normal process that occurs several times a day in healthy infants. It occurs due to transient relaxation of the LES (lower esophageal sphincter) this sphincter or valve is present at the junction of the esophagus and stomach and prevents stomach contents from entering into the esophagus. The valve relaxes during feeding and swallowing to allow food to enter into the stomach. Also, occasional transient relaxations occur during non-feeding times to allow air to vent out from the stomach (belching) and secretions to pass down into the stomach. During these times, stomach contents may enter into the esophagus.Most episodes of reflux in healthy infants last 3 minutes, after feeding and causes few or no symptoms.
In infants, diagnosis is based on reported history of baby spitting up and no tests are usually necessary unless reflux is causing symptoms. In which case it is called Gastroesophageal reflux disease.
If a child is suspected of having Gastroesophageal reflux disease, tests done depends upon what is found after a complete medical history and physical examination and may include:
•Laboratory testing (blood and/or urine tests)
•X-ray studies to evaluate how well the infant swallows
•A procedure, called upper endoscopy, to view the lining of the esophagus
Most spitting up is normal. You don’t have to do anything. Babies usually spit up once or twice after feedings. If your baby is spitting up more than twice you may consider decreasing the volume given at each feeding or space out your baby’s feedings. Other reflux precautions that your doctor may suggests includes Reflux Precautions
1.Feed less volume, but more frequently
2.Reflux is worse when babies lie on their backs; you may have to elevated the head of baby’s bed after feedings
3.Avoid compressing baby's tummy/abdomen after feeding
4.Burp baby well after feeding
5.Position infant in a semi- upright or sitting position during feeding <br/6.Ensure good latch to minimize air swallowing
7.Eliminate caffeine, tobacco when breast-feeding.
8.Trial of infant formula thickener such as rice cereal/simply thick
9.A Trial of cow's milk-free diet – (suggested by your doctor.)
When your baby is not a “happy spitter’ or has symptoms other than regular spitting up- such as coughing, being irritable, poor weight gain. Other symptoms includes:
1.Consistent forceful vomiting
3.Blood in vomit
4.Consistently forceful vomiting
5.Onset of vomiting after 6 months of life
6.Failure to thrive
These are some of the factors that your baby’s reflux may now be Gastroesophageal reflux disease and need further evaluation by your doctor
Infants with uncomplicated reflux do not require treatment other than the suggestions outlined above in the reflux precautions. Many infants with symptoms of reflux will improve, as they get older. Most infants stop refluxing after 1 year old with conservative measures alone
When reflux is causing secondary complications such as weight loss, then it is called Gastroesophageal reflux disease and this may be treated with medications provided by your doctor.