CLINICAL GASTROENTEROLOGY Focus PAEDIATRIC GASTROENTEROLOGY
STOPPING REFLUX
Infant reflux occurs when food refluxes from a baby's stomach, causing the baby to regurgitate.
Sometimes called gastrooesophageal reflux disease (GORD), the condition is rarely serious and becomes less common as a baby gets older. It's unusual for infant reflux to continue after 18 months. Reflux occurs in healthy infants multiple times a day. As long as the infant is healthy, content and growing well, the reflux Adco-Mayogel A4 Rarely, Advert 0421 V4 is not a cause for concern.
infant reflux can be a sign of a medical problem, such as an allergy, a blockage in the digestive system or GORD.
HOW INFANT REFLUX OCCURS
In infants, the ring of muscle between the esophagus and the stomach - the lower esophageal sphincter (LES) - is P.pdf 11:08 AM not yet1fully2021/04/08 mature. That allows
stomach contents to flow backward. Eventually, the LES will open only when the baby swallows and will remain tightly closed at other times, keeping stomach contents where they belong. The factors that contribute to infant reflux are common in babies and often can't be avoided. These factors include: • Babies lying flat most of the time • An almost completely liquid diet
• Babies being born prematurely. Occasionally, infant reflux can be caused by more-serious conditions, such as: • GORD: The reflux has enough acid to irritate and damage the lining of the esophagus. • Pyloric stenosis: A valve between the stomach and the small intestine is narrowed, preventing stomach contents from emptying into the small intestine. • Food intolerance: A protein in cow's milk is the most common trigger. • Eosinophilic oesophagitis: A certain type of white blood cell (eosinophil) builds up and injures the lining of the oesophagus.
COMPLICATIONS
Infant reflux usually clears up by itself without causing problems for your baby. If your baby has a more-serious condition such as GORD, he or she might show signs of poor growth. Some research indicates that babies who have frequent episodes of spitting up may be more likely to develop GORD during later childhood.
DIAGNOSIS
If testing includes: • Ultrasound: This imaging test can detect pyloric stenosis. • Lab tests: Blood and urine tests can help identify or rule out possible causes of recurring vomiting and poor weight gain. • Oesophageal pH monitoring: To measure the acidity in the baby’s oesophagus • X-rays: Can detect abnormalities in the digestive tract, such as an obstruction. Your baby may be given a contrast liquid (barium) from a bottle before the test. • Upper endoscopy: Tissue samples may be taken for analysis. For infants and children, endoscopy is usually done under general anesthesia.
SELF-MANAGEMENT
To minimise reflux, the baby should be fed in an upright position. It is recommended to hold the baby in a sitting position for 30 minutes after feeding. Gravity can help stomach contents stay put. Be careful not to move the baby too much while the food is settling. Try smaller, morefrequent feedings, taking time to burp the baby. Frequent burps during and after feeding can keep air from building up in the baby's stomach. Most babies should be placed on their backs to sleep, even if they have reflux.
References available on request. 19107 Gaviscon Infant JournalAd R.indd 1
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