Reflux in children
What is reflux?
Most people experience the unpleasant indigestion discomfort known as reflux, or heartburn, at some time or another. Due to acid from the stomach spilling back up the oesophagus (gullet), this usually happens after over-indulgence in food or drink. Less well known is the fact that many babies and small children also experience this problem, which often causes much distress in children and anxiety for parents.
Reflux in babies and children
A small amount of vomiting is common in many babies after a feed. Provided the baby is not distressed, and is gaining weight, this can be considered normal. Usually the food ‘spills’ out of the baby's mouth. This is due to delayed development of the valve between the lower end of the oesophagus and the stomach. As time goes by, this valve starts to function normally and food stays where it belongs — in the stomach, and carries on into the intestine.
But in some babies and small children this ‘normal’ reflux can cause significant problems. The baby may fail to grow due to inadequate food remaining in the digestive system. Stomach acid can irritate the oesophagus to such an extent that the baby is in pain. This will often show up as crying after feeds, having ‘colic’ or a general tummy ache. Bleeding may occur, producing iron-deficiency anaemia. Regurgitated food may be inhaled (breathed in) into the lungs, causing chronic coughing, wheezing or even pneumonia. Fortunately these complications are all rare, but they are all potentially serious.
Managing reflux
There are several ways of dealing with the problem.
In most babies who are otherwise well and thriving, no action is needed except to minimise the mess and extra washing necessary when food is regurgitated over the baby's clothing.
In more serious cases, particularly if the baby is failing to thrive, some tests may be needed. These might include X-rays, measurement of the acid in the stomach and even endoscopy, in which a tiny telescopic tube is passed into the baby's stomach to see what is going on.
A variety of treatments are available. Feeding and nursing the baby in a ‘head up’ position may solve the problem. Thickening feeds is sometimes tried, but with limited success, and only applies to bottle-fed babies. Medications such as antacids may sometimes be prescribed, but should only be tried on your doctor's advice.
In very severe cases surgery is needed to re-establish the valve mechanism between stomach and oesophagus. Fortunately this is only rarely required.
If your baby is distressed after feeds, vomits frequently and is slow to gain weight, talk to your doctor about reflux. Some simple measures may well solve the problem.
Last Reviewed: 12 October 2009
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