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Gastroesophageal reflux in infants

Definition

  

Gastroesophageal reflux is a condition in which stomach contents travels backward from the stomach to the esophagus, rather than down through the digestive system. This article discusses reflux in infants.


Alternative Names

  

Reflux - infants


Causes, incidence, and risk factors

  

In infants, a small amount of gastroesophageal reflux is normal. Persistent reflux with frequent vomiting leads to irritation of the esophagus. Reflux associated with weight loss or reflux that causes breathing difficulty is considered abnormal.


Symptoms

  
  • Chronic cough
  • Excessive crying as if in pain
  • Excessive vomiting during the first few weeks of life
  • Extremely forceful vomiting
  • No breathing or breath-holding spells
  • Slow growth
  • Weight loss
  • Wheezing

Signs and tests

  

The baby may have a history of breathing in foods or fluids into the lungs, leading to aspiration pneumonia.

Tests that may be done include:

  • Esophageal pH monitoring to determine how often and for how long stomach acid enters the esophagus
  • X-ray of the esophagus

Treatment

  

If your baby has reflux problems, hold him or her upright for 1 to 2 hours after feeding.

When the infant begins to eat solid food, thickened foods are preferable to thin foods.

Sometimes medicines are used to help reduce symptoms, such as antacids or a prescription drug called metoclopramide (Reglan).


Support Groups

  


Expectations (prognosis)

  

The majority of infants outgrow this condition. In unusual cases, reflux may persist into childhood and can cause varying degrees of esophageal damage.


Complications

  
  • Aspiration pneumonia caused by stomach contents passing into the lungs
  • Irritation and swelling of the esophagus
  • Scarring and narrowing of the esophagus

Calling your health care provider

  

Call your health care provider if your baby is vomiting frequently, especially if the vomiting is forceful or if other symptoms of reflux occur.


Prevention

  

Hold your baby upright for some time after meals. Hold your baby upright for some time after meals.


 
Review Date: 9/28/2007
Reviewd By: Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Also reviewed by Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Reviews provided by VeriMed Healthcare Network. (10/13/2006)
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