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What causes reflux? |
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| Most cases of infant reflux are caused by immaturity of the LES (lower esophageal sphincter) or muscle between the stomach and esophagus. When working properly, this muscle opens to allow food to pass through into the stomach and closes again once it has. Most babies with reflux will simply have minor coordination problems with this muscle that will eventually improve in time. |
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My baby shows only two signs of the ones listed; does this mean that he/she doesn’t have GER/GERD? |
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| No, one symptom alone could indicate reflux. The first step is to look at the would be to look at the 14 steps to improve infant reflux and and contact your physician about your concerns. |
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What is the difference between GER and GERD? |
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| GER (Gastro Esophageal Reflux) represents a benign condition in which the child is having frequent "reflux" episodes. This is also called "Functional GER" and does not cause complications, lead to long term problems, affect growth or development or even necessarily require medical intervention. GERD (Gastro Esophageal Reflux Disease) is when complications arise. GERD is a pathological process and the complications can be typical (failure to thrive, feeding and oral aversions, esophagitis, etc) or atypical (wheezing, pneumonia, chronic sinusitis, etc). Patients with GERD have complications arising from their GER that necessitate medical intervention. |
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What are the symptoms? |
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| Uncomplicated
* constant or sudden crying or colic like symptoms
* irritability and pain
* poor sleep habits typically with frequent waking
* arching their necks and back during or after eating
* spitting-up or vomiting
* wet burp or frequent hiccups
Complicated
* refusing food or accepting only a few bites despite being hungry
or the exact opposite requiring constant small meals or liquid
* food/oral aversions
* anemia
* excessive drooling
* running nose, sinus infections
* sinus congestion
* frequent ear infections or sinus congestion
* swallowing problems, gagging, choking
* chronic hoarse voice
* frequent red, sore throat without infection present
* apnea
* respiratory problems—pneumonia, bronchitis, wheezing, asthma, night-time cough, aspiration
* gagging themselves with their fingers or fist (sign of esophagitis)
* poor weight gain, weight loss, failure to thrive*
* erosion of dental enamel
* neck arching (Sandifer's Syndrome)
* bad breath |
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What is silent reflux? |
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| Not all infants suffering from reflux actually vomit; some may have what is termed ‘silent’ reflux- where the stomach contents only come part way up the esophagus. Because there is no vomiting the it is harder to tell. Some children may swallow the refluxed material (refluxate) back down instead of throwing it up, in some kids it may not come up enough to actually come out the mouth. This can be much more difficult to diagnose, since the most common symptoms are not present. It can also be more damaging as the refluxate burns the esophagus on the way up and again on the way down. Whether or not the silent reflux needs to be treated depends on the complications that are arising from it. |
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What are the symptoms of silent reflux? |
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| All the symptoms listed above but no outward symptoms such as vomiting and sometimes burping. Keep a journal of events to take with you to the doctor to make it easier to diagnose. |
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How do I tell the difference between reflux and colic? |
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| The main differences is that with colic the child will pull up his legs and scrunch them in pain and will generally be irritable/cry for a few hours a day, mainly in the late afternoon. With reflux instead of scrunching the legs, they will arch their back, in an attempt to straighten the esophagus and decrease the pain, crying/irritability will generally last a lot longer, will usually occur during or after feedings and can go all day. |
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How do I know that my baby needs treatment? |
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| This is usually easily determined by the infant's quality of life and the complications (if any) they are experiencing. For more information, see the article on the decision to medicate. |
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What are the complications of GERD? |
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| Failure to thrive, food and oral aversions, chocking, gagging, apnea, aspiration, asthma, anemia and many more, read more in the complications of GERD article. |
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I’ve been told since my baby is gaining weight that their reflux is nothing to worry about, but he/she cries all day. What do I do? |
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| Read our tips for getting taken seriously, getting a diagnosis and try some of the tips we mention. If that doesn't work, try video taping the infant or keeping a dairy of the crying. |
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How do I know if it's just reflux or something more serious in my child? |
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| Well first, the something more serious could easily be GERD. Read about the differences between the two here.
Beyond that, generally if a baby responds well to treatment, either medicinal or otherwise, it's a good assumption that it's reflux or GERD. If a baby isn't responding well to treatment and symptoms persist despite maximum medical efforts then the pediatrician or GI will likely begin further investigation to rule out other issues. It is very possible that even if the baby isn't responding to every effort you are making to treat their GERD they still just have GERD and nothing else. Some cases of GERD just seem to refuse to be successfully treated. |
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