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 92 Pitt St
Sydney NSW 2000
ph: (02) 9221 0091
fax: (02) 9221 0090

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:: Infant Reflux

Healthy Children & Teens - Infant Reflux
  Healthy Children & Teens
  Infant Reflux

Infant reflux is the regurgitation of milk and stomach acid by a baby, which can cause the baby pain and which causes distress to both the infant and parents.  Gastro-oesophageal reflux (GOR/reflux) occurs when food and stomach acid flows back into the oesophagus (foodpipe).

For some babies, this causes no problems, but for others, it can be a significant problem that requires medical treatment, investigation and for a very small percentage, surgery. The exact cause is unknown, but may be associated with an immature digestive system, hereditary factors, food sensitivities, and other medical issues.
 

Signs & Symptoms:

The list below outlines some of the more common signs of reflux that may require treatment:

  • vomiting / posseting / regurgitating
  • irritability / excessive crying
  • appearing to be in pain
  • feeding problems
  • refusal to feed or only taking a small amount despite being hungry
  • comfort feeding - feeding frequently
  • pulling away and arching their back
  • crying during or after feeds
  • gagging/spluttering
  • sleeping issues
  • catnapping during the day
  • frequent night waking (though some refluxers do sleep well at night)
  • easily disturbed from sleep
  • wheezing/coughing
  • failure to thrive
  • recurrent chest infections

Medication

  • Antacids may help with fussy feeds when given at the time of a feed, or may work best given ½ to 1 hour after the feed when acid levels will be highest
  • Paracetamol may be useful to relieve discomfort, but if you find you are using it regularly, check with your pharmacist
  • Medication to reduce acid secretion in the stomach
  • Medication to block acid production more completely
  • If the baby does not improve with 1 to 2 weeks of any medication, its use should be reassessed. These medications do not help all babies, whether they actually have reflux or not

Management:

  • Keep your baby upright for at least 30 minutes after a feed
  • Use a baby sling, which allows you to keep your child upright, while keeping your hands free. Avoid baby slumping
  • Try elevating the head of the cot/bassinet
  • Consider using a dummy
  • Avoid vigorous movements or bouncing the baby
  • The best time to lay your baby on the floor is when baby's tummy is empty, i.e. before a feed
  • Change nappy before a feed. Take care to elevate the baby's head and shoulders. Avoid lifting the legs too high, and turn to the side if possible
  • Avoid any tight clothing around the waist, such as tight nappies, elastic waistbands
  • Avoid overfeeding - if the baby vomits, wait until the next feeding rather than feeding them again. You should consult your doctor or child health nurse to ensure that you baby is getting appropriate nutrition
  • If the baby is bottle-fed, it may be worthwhile trying AR (anti-reflux) formula, or a hypoallergenic one.
  • Offer a spoonful of thickened milk (formula or breastmilk) following the feed - discuss the type of 'thickener' with your healthcare provider before starting this.
  • If breastfeeding, the mother should avoid eating foods that can aggravate reflux such as citrus, tomato, fatty foods, spicy foods, chocolate and carbonated drinks.
  • Some reflux children may suffer from food sensitivities, and may need dietary restrictions (or the mother may consider an elimination diet). If you suspect foods may be responsible for your child' condition, it is essential to discuss this with your health care provider. Do not change your or your child's diet before seeking medical advice.
  • Avoid exposure to tobacco smoke.
     

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