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The ABCs of Pediatric Reflux

Published by , on Nov 15, 2012

By Robert E. Kane,  MDProfessor, Division of Gastroenterology and Nutrition, Virginia Commonwealth University As an adult you may have experienced heartburn or an uncomfortable feeling in your chest after eating a big meal or spicy food. From time to time this is normal, but if these symptoms occur frequently it may be due to gastroesophageal reflux disease (GERD).But GERD isn’t just a problem for adults — it affects kids, too. In babies with GERD, breast milk or formula regularly refluxes into the esophagus, and sometimes out of the mouth.  Infants experience this more often when their stomach is full or their position is changed abruptly, particularly after feeding.Some infants may regurgitate forcefully or experience “wet burps” or fussiness after feeding. Since spitting-up after eating is a common occurrence during a child’s first year of life, GERD can be difficult to detect. The most common symptoms of an infant with GERD include spitting up frequently, becoming inconsolably upset (colic) especially after a feeding and some infants may even refuse to eat. Infants with severe GERD may experience wheezing or failure to gain weight.The good news is that being aware of the symptoms can help you manage your child’s GERD. Feeding your baby smaller amounts of food more frequently helps, since GERD symptoms can increase if a baby’s stomach is too full. Placing your baby in an upright or seated position during feeding may also help reduce reflux symptoms. If your baby is bottle-fed, your pediatrician may suggest lightly thickening the formula or breast milk with a very small amount of rice cereal to reduce reflux. Before doing so you should talk to your pediatrician as this may add unnecessary calories to your babies diet and could cause problems when it’s time to introduce solid food.With older children GERD is easier to diagnose and typically surfaces as heartburn, stomach or chest discomfort. Children with severe symptoms may complain of abdominal pain and experience frequent vomiting after eating.To minimize reflux, older children should avoid eating or drinking foods and liquids that noticeably make symptoms occur more frequently. Some items that tend to trigger GERD symptoms include caffeine, fatty and fried foods, spicy foods and peppermint. Keeping a food journal can help you figure out what types of foods trigger reflux in your child. If your child experiences reflux at night, your pediatrician may recommend extending the time between dinner and bedtime, or raising the head of a child’s bed 6 to8 inches to minimize reflux that occurs at night. Your pediatrician may also prescribe antacid therapy which, depending on a child’s level of discomfort, may include liquid antacids such as Children’s Pepto Bismol.Unfortunately, GERD tends to be a chronic problem, with 60% of children needing recurring treatment within 6 months and a majority experiencing the disease throughout adulthood. Fortunately, with proper diagnosis and treatment, kids can get relief and avoid longer-term health problems.  If you believe your child is experiencing GERD symptoms, talk with your pediatrician.Are you interested in learning more about GERD? Please join the Children’s Hospital of Richmond at VCU in Fredericksburg, Va. for our free seminar, The ABCs of Pediatric Gastroesophageal Reflux Disease on Thursday, November 15.Dr. Robert Kane III, with the Division of Gastroenterology and Nutrition, will join us to discuss the causes, diagnosis and treatment of GERD in infants, children and adolescents.Register or learn more today by calling (804) 828-0123.The “Pediatric Liver Care Center” at the new hepatology clinic is now open at Stony Point. For more information call (804) 828-4060.

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