Introduction
Spitting up after eating is known as reflux. It is commonly seen in babies and disappears as the child grows. In infants, it occurs due to the developing digestive system. However, if it is in extreme and severe form, it may cause gastroesophageal reflux. The frequent spitting is associated with discomfort seen in infants. In addition, it leads to vomiting and weight loss. Some infants may have the sign of reflux, but it does not affect their health. This condition is known as silent reflux. Parents need not concern the pediatrician if their child is gaining weight and is healthy.
What Is Reflux?
The esophagus is the tube that helps carry food from the mouth to the stomach. If the newborn has reflux, the stomach contents return to the esophagus. If the symptoms of reflux are severe and persistent, it results in gastroesophageal reflux. It prevents the child from feeding resulting in weight loss.
What Are the Causes of Reflux Seen in Infants?
There is the presence of lower esophageal sphincter muscle in between the stomach and esophagus. It acts as a valve when the child swallows. The muscle relaxes as the food moves from the esophagus and stomach. However, the power usually remains intact, so the stomach content doesn't flow back. If the child's esophageal sphincter muscle is not developed correctly, the stomach content moves back to the esophagus. It causes regurgitation in the baby resulting in spitting and vomiting.
What Are the Clinical Features of Reflux?
The reflux usually peaks at the age of four months and disappears at twelve months. Following are the various signs of symptoms of reflux seen in infants.
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Vomiting and Spitting - Spitting is normal for infants. The child may spit up the green and yellowish fluid. It usually is painless. However, if there is a presence of vomiting and forceful spitting, the child feels discomfort and fussy.
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Difficulty In Swallowing - The child feels difficulty during feeding. There is a presence of pain and irritation that occurs as the content comes upward to the esophagus from the stomach.
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Irritability - The child is irritable during feeding. The child usually cries during feeding due to abdominal pain and discomfort.
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Burps - There is the presence of wet burps and hiccups. The infant spits up the liquid while burping.
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Difficulty In Gaining Weight - The child suffers from weight loss due to excessive vomiting. Weight loss is also associated with difficulty in feeding.
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Arching - The infants arch their bodies abnormally during feeding and after some time of feeding. It is caused due to the presence of a painful burning sensation in the esophagus by stomach fluids.
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Frequent Coughing - The infant frequently coughs due to the movement of food and milk back to the throat. The regurgitation of food can be inhaled into the lungs, which leads to respiratory diseases such as asthma and bacterial pneumonia.
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Gag - The infant is prone to choke and gag if the stomach's content moves back to the esophagus. The infant's position during feeding can also cause gagging.
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Chest Pain -There is the presence of heartburn and pain in the infant's chest. It is caused due to irritation in the esophageal lining.
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Disturbance In Sleep - Reflux causes difficulty in the sleep of the infant. The child feels difficulty sleeping during the night.
How Is Reflux Diagnosed in Infants?
Following are the various diagnostic methods for the diagnosis of reflux in Infants.
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Barium Swallow - It is an X-ray technique in which barium is used to observe the esophagus.
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pH Probe - In this test esophagus is evaluated. The child swallows a thin probe at the tip and stays in the esophagus for twenty-four hours.
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Upper GI Endoscopy - It is done with the help of an endoscope that allows the doctor to look directly into the esophagus.
What Is the Treatment Plan For Reflux?
Reflux is diagnosed in the child by signs, symptoms, and medical history.
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Anti-Reflux Medications - The pediatrician, should instruct the parents to change their feeding habits. If the symptoms and signs are not improved, antireflux medications are indicated. Omeprazole and Lansoprazole help suppress the symptoms of reflux in infants. Acid blocker medications such as Cimetidine and Famotidine are also given to the baby. Medication can help in reducing the stomach acid of the child.
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Intragastric Feeding - Intragastric feeding is indicated if the medication therapy fails. Continuous intragastric administration of nutrition and feed is done with the help of a nasogastric tube. This process is usually performed in preterm infants. It is indicated as an alternative to the surgical procedure in children. It helps in providing adequate nutritional management as well as medical therapy.
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Surgical Procedure -In this process, the esophagus sphincter is tightened to prevent the flowing back of the acid into the esophagus. A surgical procedure is only indicated if the reflux is severe and interferes with the infant's breathing.
What Remedies Should Parents Follow?
Following are the various lifestyle changes that parents can practice to avoid reflux in their baby.
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Parents should elevate the head of the baby's crib to prevent reflux.
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Parents should hold the baby upright for thirty minutes after the feeding.
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Parents should feed their children a small amount to manage the duration of the time.
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Parents can elevate the head of the child's sleeping bed.
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Parents should keep their children upright for some time after feeding.
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Parents should stop feeding if the child is burping.
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Parents should delay playtime the meals as the movement increases the frequency of vomiting.
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If the child is bottle-fed, the size of the nipple should be appropriate.
Conclusion
Reflux is commonly seen in newborns and can occur multiple times a day. As the child grows, it disappears, but it can get serious, sometimes resulting in weight loss and health issues in infants. The child needs treatment if the reflux continues even after eighteen months. Parents should be aware of this common digestive problem and seek healthcare if the symptoms persist.
