Tips on Helping Your Baby Though Gastroesophageal Reflux Disease (GERD)
by Suzanne Robin, RNApr 01, 2014
Gastroesophageal reflux disease -- more commonly known as GERD -- can cause your baby pain and lead you to despair. GERD is more severe than gastroesophageal reflux, or infant spitting caused by an immature lower esophageal sphincter, the valve between the stomach and esophagus. While GERD in infants is generally a self-limiting condition, usually resolving by age 12 months, it can make infants and parents alike miserable while it lasts. However, over 80 percent of babies who experience GERD improve with conservative measures, according to Wolters Kluwer Health.
As many as 70 to 85 percent of infants have gastroesophageal
reflux and spit up in their first few months, according to a February 2013
article in "Pediatric Drugs." It generally doesn't cause any
distressing symptoms beyond stains on clothing and furniture. GERD, however,
causes pain and can damage the esophagus over time, as stomach acid makes its
way into the esophagus and back of the throat. GERD can cause a baby to choke,
gag, arch his back during feedings and refuse to eat. He may fail to gain
weight and be diagnosed with failure to thrive.
Positioning Techniques That
You can help decrease your baby's discomfort from GERD with
simple feeding techniques. If you bottle-feed your baby, hold the bottle on an
angle to ensure that no air enters the nipple. If you breastfeed and have
copious amounts of milk at letdown, express a little milk before putting the
baby on the breast so that he doesn't gulp and swallow air. Keep him upright --
but not in a seated position -- for 20 to 30 minutes after each feeding to
allow gravity to help keep milk in his stomach. Avoid jostling or roughhousing
for 30 minutes after the feeding.
Between 15 to 40 percent of infants with reflux are allergic to
cow's milk, according to Wolters Kluwer Health. Switch to a milk-free formula
if you're bottle-feeding or eliminate milk from your diet for two to three
weeks to see if it helps. Thickening formula with cereal is controversial; talk
to your pediatrician before starting solids of any type. Mixing 1 ounce of rice
cereal to 1 ounce of formula may help, but it should be used only for full-term
infants, the American Academy of Pediatrics cautions. Adding cereal will also
add calories to your baby's daily intake. Let your baby decide when he's full.
Don't allow tobacco smoke around your baby, as it can worsen
GERD. If simple measures don't work to improve GERD, medications can help
reduce stomach acid pH. This reduces the burning caused by acid entering the
esophagus. Several classes of prescription medications, including antacids,
histamine-2 receptor antagonists and proton pump inhibitors can be used in
infants. Proton pump inhibitors should be given 30 minutes before a feeding. Do
not give over-the-counter acid buffers that contain aluminum to infants. They
can raise an infant's serum aluminum levels.