Reflux in Infants

Most babies vomit what they eat after eating food or drinking milk. In some babies, this is excessive and occurs very often and in these cases it is said that the baby has reflux. This occurs when the food in the stomach is thrown back into the esophagus or into the mouth. Most people have reflux from the stomach to the esophagus, but these are often not felt and we do not realize.

When babies very often vomit what they eat, parents worry and need to seek medical advice. It is generally suspected to be allergic to milk, as the baby has an obstruction in the intestine or an ulcer. However, most infants and children do not have any anatomical problems and it develops due to the child's gastrointestinal tract is not fully developed

Most babies with reflux are normal and healthy children. However, in children with neurological or developmental anomalies, reflux is a bigger problem. In these children, reflux may also prevent the development of the child due to inadequate nutrition, or lead to aspiration and lung infection.

Because babies and children are not able to fully explain their problems, the symptoms of reflux may be difficult to determine. The most common symptoms;;

  • frequent or recurrent vomiting
  • chest burn, gas or abdominal pain may occur. However, more rarely, the following symptoms also can be detected,
  • recurrent colic-style abdominal pains,
  • frequent gas extraction,
  • nutrition problems,
  • slowdown in development,
  • apnea,
  • frequent pneumonia (lung infection) attacks can be seen.
How do we treat it?

Remember that in most babies reflux is spontaneously resolved. Most of the treatments given do not correct reflux, but they are the treatments only for removing the symptoms. When adequate time is allowed, reflux will also improve spontaneously. When the babies start sitting without support at about 6th months, it will be seen that the reflux is better. When the child starts walking around 12th month, it will disappear completely in most infants.

Position

The correct position is important to reduce the reflux. After eating the food, keeping babies tilted on their bellies with head up will reduce the reflux. However, not all babies want to stand in this position and they cry, in which case the baby should be laid down on his back with the head up a little. Pillows and beds are available to keep the child in this position. The child can be kept in the desired position with the help of these pillows and beds. The crying of the baby can increase the reflux, while the children cry they contract their abdominal muscles and swallow a lot of air. And this further increases reflux.

Diet therapy

Reflux symptoms are less common in breast-fed babies.

In babies, it is generally seen that there is less reflux when the food is changed, but this is usually temporary. Generally, babies continue to vomit when change is made even if now they have breast milk. Some parents prefer to give the food after solidified with cereal products. In this case, food becomes heavy and more difficult to remove. However, this is rather difficult in breast-fed babies. Difficulties can be experienced in bottle feeding babies because it gets solid. When the baby cannot pull the food from the bottle, it can increase the reflux by swallowing more air.

When switched to feeding with solid foods and spoon feeding, reflux will be less. Solid food is more difficult to remove. It is believed that babies will become more allergic in the future when solid foods start early, but there is no evidence to prove this.

It is recommended that parents feed more frequently and with less food or milk. But babies often cry, not accepting less food. This may worsen reflux.

Children's use of false pacifiers may also be useful in the treatment of reflux. The pacifier increases the salivation in the child and reduces the likelihood of reflux by increasing bowel movements.

Mothers feeding her child with breast milk to consume too much caffeinated beverages, or the child's exposure to cigarette smoke will lead to increased complaints of reflux in the child.

Drug therapy (Medication)

Antacid therapy, H2 receptor blockers, proton pump inhibitors, and drugs can be used in children who require drug therapy. The most commonly used medical drugs are; alginate antacids (Gaviscon® infant powder), H2 receptor blockers (Zantac® suspension), and sometimes additionally prokinetic agents (Motilium® suspension). H2 receptor blockers and proton pump inhibitors can be used in children.

Surgical

There is no need for surgery for the treatment of reflux in the majority of children. The most common treatment for a few children that need treatment is Nissen fundoplication. In this operation, the upper part of the stomach is wrapped around the esophagus. Thus, when the stomach is contracted, the part that is wrapped also contracts and closes the esophagus.