Handle your baby gently and try to refrain from jiggling within the first hour after a meal. What about managing more severe reflux? Here are a few ideas to discuss with your doctor to help manage more severe reflux: Babies who have cow milk protein allergy may experience similar symptoms of GERD. Consider a 2-week cow milk elimination trial. Ask your doctor about a hypoallergenic formula trial.
Thickened feeding may improve slightly the occurrence of regurgitation and spit up. For formula thickening, use rice cereal with low or no arsenic. You will not be able to thicken breastmilk with rice cereal since it will be digested by amylases found in breastmilk. Discuss with your doctor the safety profile for various commercial thickeners. If your baby is having trouble gaining weight, feedings with higher calorie content or tube feeding may be recommended.
Reflux usually peaks at 4 — 5 months of life and stops by 12 — 18 months. Spitting up crosses the line into GERD when the infant develops troublesome symptoms.
Rarely, serious complications of GERD can lead to weight loss or significant respiratory difficulty. Subscribe to our newsletter and get free parenting tips delivered to your inbox every week! Related Content. Previous Next. Posts from Catherine Chao, MD. Turn off more accessible mode. Skip Ribbon Commands. Skip to main content. Turn off Animations. Turn on Animations. Our Sponsors Log in Register. Log in Register. Ages and Stages. Healthy Living. Safety and Prevention.
Family Life. Health Issues. Tips and Tools. Our Mission. Find a Pediatrician. Text Size. Page Content. So, how do you know if your spitty baby's symptoms are normal or part of a larger problem? When is spit-up or GER normal? What are the causes of GER? How will my pediatrician evaluate my baby for GER? Treatment options during infancy: Burp at natural pauses in feeding and keeping your child upright for up to thirty minutes after feeding.
Treatment options for an older child: Avoid fried and fatty foods; they slow down the rate of the stomach emptying and promote reflux.
When might my pediatrician refer my child to a pediatric gastroenterologist? Your pediatrician may refer your child to see a pediatric gastroenterologist , a pediatrician who has specialized training in problems of the gastrointestinal tract—including GERD—for a variety of reasons including: Poor weight gain Feeding problems No response to medical therapy A pediatric gastroenterologist will review your child's history, examine your child and review his or her diet history and growth charts.
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
Follow Us. Back to Top. Chronic Conditions. Many parents may come across signs or symptoms of GERD in their research across the internet. This can be very confusing since many of the symptoms or behaviors of GERD, like arching of the back or intermittent fussiness, overlap with those seen in babies without GERD.
Some more concerning signs or symptoms of reflux but not diagnostic of GERD include:. Normal, physiologic reflux is thought to be caused by relaxation of the muscle between the esophagus and stomach, the lower esophageal sphincter LES. In infants, the LES is thought to strengthen with time as reflux diminishes.
After meals and with certain foods, the LES may relax more, contributing to physiologic reflux in infants, children, and adults. In adults and older children, certain medical conditions, obesity, and lifestyle are associated with reflux. In children, underlying medical conditions, like neurologic syndromes, genetic disorders, and anatomic abnormalities contribute to pathologic reflux.
These children more often need diagnostic studies and intervention as compared to children without any underlying conditions. It is wise to consult with your health care provider before assuming your child has GERD. Since many of the symptoms and behaviors of babies with complicated reflux are present in normal infants, distinguishing GERD from uncomplicated normal reflux is a challenge for both parents and healthcare providers.
There is no single test or set of tests that confirms the diagnosis of reflux. However, in some atypical or more severe cases of suspected GERD, your doctor may order some tests:. The test is performed by having your baby drink some fluid that is then seen over a series or X-rays.
Note that fluid is often seen flowing back up into the esophagus during this study. This is expected since some level of reflux is normal in everyone. In other words, seeing reflux during an upper GI series is not diagnostic of reflux. Considerations: Though not invasive, it is important to note that an upper GI series will expose your child to some radiation, as all tests involving X- rays or CT scans do.
A pH probe placed inside the esophagus can measure the acidity present. It is done under the care of a pediatric gastrointestinal specialist. The probe is usually left in place for hours to measure the frequency and duration of acid in the esophagus.
This test is not diagnostic of GERD since the presence of reflux or acidity in the esophagus is not necessarily correlated with symptoms. Though there are rarely severe complications, the placement of the probe can be uncomfortable, especially if your child resists. It is sometimes difficult to keep the probe in place if a child does not cooperate. Correct placement of the probe may be confirmed by X-ray though this is not usually necessary. Children may need to fast prior to placement of the probe.
Esophageal impedance testing: This test measures the presence of refluxed material in addition to pH monitoring. As such, it can differentiate between. This may be important in situations where a baby does not respond to typical treatment. This may be uncomfortable for your child.
Usually patients are asked to fast for several hours prior to the placement of the probe. Upper endoscopy: This test is reserved for very severe cases. A pediatric gastroenterologist performs endoscopies in an outpatient center or hospital.
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