Acid Reflux in Infants and Children-GERD

July 2, 2022July 2, 2022 Rita Uzuh SPRING HEALTH METRO

GER (gastroesophageal reflux) in infants and children is a relatively common disorder where there is reflux of stomach acid into the esophagus and oral cavity in a newborn or infant child. Generally, no therapy is necessary and the condition resolves with a “tincture of time.”
GERD (gastroesophageal reflux disease) is a disease where the reflux of stomach acid into the esophagus and oral cavity is chronic in nature. In infants and children, it is much less frequent when compared with GER. The “disease” of GERD implies the need for various therapeutic approaches to minimize the consequences of reflux of stomach acid into the esophagus and oral cavity.
Signs and symptoms of GER or GERD in infants and children overlap. Infants and children with GER have obvious reflux of breastmilk and/or formula following feeding. Usually, such infants do not appear to be in distress by such episodes.
Signs and symptoms of GERD in infants and children include:
- Fussiness during and after feedings
- Cough
- Rarely, wheezing may follow feedings
- More forceful expulsion of stomach contents than do infants and children with GER.
GER and GERD in infants and children are caused by immature neurologic and gastrointestinal systems. In both GER and GERD, the stomach contents are expelled from the stomach into the esophagus through the opened gastroesophageal junction. Generally, this junction is closed and stomach contents may only travel from the stomach into the intestinal tract.
GER and GERD in infants and children are diagnosed with a thorough history and physical exam by the child’s pediatrician. Infants with GER are thriving children and do not have recurrent agitation or forceful ejection of breast milk/formula. They maintain good weight gain. No blood or X-ray tests are indicated. Infants experiencing GERD have often a forceful ejection of stomach contents, have periods between the feeding of agitation and fussiness, may have episodes of arching twisting between feedings, and may have slow weight gain due to inadequate caloric intake. Recurrent cough or (in rare cases) wheezing may be associated with GERD. In some circumstances, radiology or other studies may be necessary. A consultation with a pediatric GI specialist (gastroenterologist) may be necessary.
Treatment for GER and GERD in infants and children include mild elevation of the infant for 15-30 minutes following a feeding, serving smaller but more frequent feedings, and thickening of formula or pumped breast milk with rice cereal. In older children, it is worthwhile to maintain a dietary journal to help identify GERD and food relationships. Carbonated or caffeinated beverages may be associated with GERD. In some cases, medications may be indicated.
Natural remedies to help GER and GERD symptoms in infants and children include thickening of pumped breast milk or formula with rice cereal, smaller and more frequent feedings, the elevation of the infant for 15-30 minutes following feeding and (in rare cases) use of an “elemental” formula for infants with milk or soy protein sensitivity in association with GERD.