What Is GERD?
The esophagus is a tube that carries food from the mouth to the stomach for digestion. GERD (gastroesophageal reflux disease) is a digestive tract disorder that causes reflux of food through the esophagus. It is also commonly known as acid reflux, acid indigestion, or heartburn. Usually, it does not cause any severe symptoms in the infants and resolves on its own when the infants grow up.
What Is GERD in Infants?
Gastroesophageal reflux (GER) is characterized by the passage of stomach contents into the esophagus, which may or may not be associated with regurgitation. It might sometimes be accompanied by spitting up and vomiting.
GERD, a reflux disease, causes repeated GER symptoms that are worrisome and may lead to medical complications. The diagnosis of gastroesophageal reflux (GER) and GERD is based on history and physical examination. GER and GERD are commonly seen in infants and it is usually resolved on their own when the baby grows 12 months old. It is a normal physiologic process that occurs throughout the day in infants. The occurrence of this reflux is less common in children and adolescents.
What Causes GERD in Infants?
Studies have shown that numerous factors contribute to GERD in infants. Some of these factors include:
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The infants spend most of their time sleeping during the first six months.
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They will not have a fully developed esophagus and lower esophageal sphincter during this period.
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The babies are more dependent on liquid food at this stage.
These factors might cause the stomach content to come out through the esophagus and reach the mouth. However, when the infant grows and eats more solids and spends more time in upright positions, the symptoms of GERD reduce gradually on its own.
Infants have a definite possibility of developing GERD if they have the following health conditions:
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Premature birth.
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Cystic fibrosis.
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History of previous surgery for esophageal atresia.
What Are the Symptoms of GERD in Infants?
GERD commonly causes regurgitation (stomach contents coming out through the esophagus either into the throat or mouth) or spitting up in infants.
Apart from this, it can also affect the infant's life by causing:
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Choking, gagging, or problems with swallowing.
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Irritability because of regurgitation.
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The baby might refuse to eat or swallow, leading to loss of appetite.
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The baby spits up green or yellow fluid.
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Abnormal movement of the neck and the chin.
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Poor weight gain.
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Wet burps and hiccups.
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Coughing and wheezing.
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Vomiting.
How to Diagnose GERD in Infants?
The doctors attempt to review your infant's symptoms and medical history. If your doctor suspects GER or GERD, they might suggest some lifestyle modifications to overcome this problem. However, if the symptoms are severe, your doctor might recommend some tests to rule out GERD. The tests for diagnosing GERD include;
1. Upper Gastrointestinal (GI) Endoscopy:
It is a procedure in which a flexible tube with a camera is inserted to check the lining of the upper GI tract, including the esophagus, stomach, and duodenum. Sometimes, a doctor might take a small piece of tissue for biopsies if needed.
2. Esophageal pH Monitoring:
Esophageal pH monitoring is done to detect acid reflux in the esophagus. Your doctor might suggest this test to detect nonacid reflux. The doctor inserts one end of a flexible catheter into the esophagus through the nose of the infant. The catheter is connected with a monitor for diagnosing the GERD condition. This test can help the doctor detect sleeping, eating, and other esophageal reflux problems. It can also provide an idea about the effectiveness of GERD medicines.
3. Upper GI Series:
It is a procedure in which a doctor uses barium to visualize the upper GI tract with X-rays. It is used primarily to detect anatomic problems of the esophagus and upper GI tract to determine the reasons for symptoms worsening.
What Is the Treatment of GERD in Infants?
Mainly, the infants do not require any treatment as the conditions resolve on their own when the infants turn 12 months or older. The doctor might recommend some diet modifications depending on the age and symptoms experienced by the infant. They will ask you to hold your baby upright for 15 minutes to 20 minutes after feeding. You should avoid exposing the infant to passive smoking. However, based on the severity of the condition, your doctor might suggest some medications. Surgery is usually not recommended and is an option only when the infant is unresponsive to all other treatment modalities.
What Are the Most Recommended Diet Modifications That Can Improve GERD in Infants?
If you suspect GERD signs in your baby, you should avoid doing any lifestyle modifications without consultation with your doctor. Depending on the age and the symptoms of the infants, your doctor will suggest changes in your baby's diet plan such as,
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Frequent breastfeeding and avoiding overfeeding.
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Add cereals to the formula or stored breast milk to make it thicker.
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Remove cow's milk from the diet as many infants are allergic to the protein in cow's milk and may exhibit signs similar to GERD.
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Additional calorie intake if your baby is showing poor weight gain.
You must follow the diet guidance plan of your doctor as they would suggest a balanced diet that is essential for your baby's growth and development.
What Are the Associated Complications of GERD in Infants?
The infant with GERD might develop some complications, either concerning the esophagus or some outside esophagus if appropriate treatment is not given in time; the commonly known complications are:
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Esophagitis.
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Poor weight gain.
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Complications outside the esophagus include cough, pneumonia, wheezing, or laryngitis.
Conclusion:
GERD is commonly reported in breastfeeding infants. Some studies support that its occurrence in infants might be due to spending long hours in a lying position while sleeping and intake of more liquid food. Various research is being conducted to detect the reason for its increased prevalence in infants than adolescents and children. If you notice frequent gagging or spitting up in your infant, it is advisable to seek the help of your physician at the earliest to get it sorted.
