Gastroesophageal reflux disease, or GERD, is the involuntary rise of stomach contents into a baby’s esophagus. Common in infants, it causes regurgitation. Without seriousness, it can however be responsible for esophagitis.
In newborns or infants under one year of age, gastroesophageal reflux disease (GERD) is a common occurrence and not serious. Regurgitation occurs in almost two-thirds of children aged 4 to 5 months. They only concern 5% of children aged 10 and 12 months, a period of acquiring the standing posture and then walking.
First recognize the type of gastroesophageal reflux disease:
- Simple GERD is the most frequently encountered case: it is not serious. It is a benign condition of the baby that heals spontaneously with the acquisition of a standing position. Regurgitation is well tolerated. Even if the baby regurgitates, his appetite is preserved. He is growing well and getting bigger steadily. This type of reflux only requires hygienic and dietary management and generally disappears when you learn to walk.
- GERD complicated by esophagitis: it is much rarer in infants. The acidity of regurgitation causes inflammation of the lining of the esophagus or esophagitis.
Bothersome symptoms appear: regurgitation with traces of blood, crying, refusal of food, weight loss, restlessness after taking bottles or during sleep … Examinations and drug treatment are necessary.
Causes of GERD in infants:
We must not confuse rejection, gastroesophageal reflux and vomiting.
A rejection is due to too much milk, it is a little bit of liquid that rises to the corner of the mouth after a meal.
Reflux is similar to rejection, but it lasts longer until the next feed and can be acidic and painful. Two hours after taking milk, he may still regurgitate. In both cases, this referral is passive: the content goes up on its own.
Vomiting, on the other hand, is active: you have to make an effort to vomit.
How is it diagnosed?
Using a PH metric, an examination that is done on an outpatient basis at the hospital. The doctor slips a very thin tube through the nose that goes down into the esophagus and places a small box measuring the acidity for 24 hours (how many times the reflux, etc.) Is also prescribed a fibroscopy which allows samples to be taken from the the esophagus. These highlight the consequences of GERD, namely the degree of esophagitis.
What remedies are recommended for GERD?
For simple GERD
• Keep baby upright at least half an hour after bottle feeding, burping is welcome. The bad idea is to put it back down very quickly. Use and abuse the bib, diaper, etc., to limit the damage.
• Continue to lay him on his back and flat. Certainly, the reflux decreases when lying on his stomach. However, the ventral tilting position (on the stomach and on a 30 ° slope) has not been recommended for years. As for the dorsal windward position (on the back and on a slope), it has never proven its effectiveness. There is also a risk that the baby will roll to the bottom of the bed if it is not properly secured.
• Do not over-tighten the diaper to aid the infant’s digestion. Things get a little better when it comes to food diversification, when the food gets solid. But the real improvement occurs between 12 and 15 months, at the age of walking. The upright position “straightens” the stomach, the pressure in the abdomen is less strong… and the maturity of the digestive system is made! No more GERD.
For complicated GERD:
Infant gastroesophageal reflux disease is only treated if it is late, acidic, smelling of vomit and causing the baby to cry. Avoid getting the acid to irritate the lower esophagus (creating esophagitis) or back up the throat. This can indeed create laryngitis, cause coughing, sore throat and ENT (otolaryngological) complications.
Treatments for complicated baby’s GERD: To decrease the acidity of the esophagus, there are only antisecretory drugs of the Mopral type. The lesions heal and disappear, but the reflux is still there.
In case of complicated GERD, the doctor may prescribe a small gastric bandage, to be given between feedings.
Breast milk is the ideal and natural food for every infant. If you cannot or have decided not to breastfeed, talk to your doctor so that he can recommend an infant formula for your child who is prone to reflux.