Reflux
Regurgitation or
posseting is very common and occurs daily in about 50% of babies. This usually spontaneously resolves in most babies by about 12 months.
Gastro-oesophageal reflux (GOR) is also common and occurs with similar frequency in both breast fed and bottle fed babies and again this usually resolves spontaneously by 12 months. Reflux occurs because the muscular ring at the lower end of the food pipe (oesophagus) is not yet fully developed and it can allow the contents of the stomach to flow back into the food pipe when the stomach is full. This often occurs without regurgitation or posseting.
Gastro-oesophageal reflux disease (GORD) is however associated with more severe symptoms such as poor weight gain, irritability and excessive crying, feeding difficulties, food refusal, breathing problems and in some cases inflammation of the oesophagus. There is an increased incidence of GORD in babies with certain genetic and neurological problems.
Treatment
- Changes in feeding patterns. Try offering smaller more frequent feeds so that your baby’s tummy is not as full.
- Try to keep your baby in an upright position for about 20 minutes following a feed.
- Raise the head of the mattress slightly in your baby’s cot.
- Wind your baby frequently between and after feeds.
- Try loosening the tabs on your baby’s nappy so that there is less pressure on a tummy full of milk.
If however, your baby is failing to gain weight, is struggling with feeds, is irritable and unhappy or has other complications of reflux then other treatments may be recommended by either your GP or Paediatrician.
- Medications that thicken the stomach contents (i.e. Infant Gaviscon) that makes it more difficult for the stomach contents to reflux into the food pipe.
- Medicines that reduce the acidity of the stomach contents (i.e.Ranitidine and Omeprazole) and those that increase the stomach emptying time (i.e. Domperidone).
- Specialised formula milks – pre-thickened and anti-regurgitation (AR) feeds.
- As GORD may be associated with Cow’s Milk Protein Allergy, a specialised hydrolysed formula milk (where the protein in the milk has been broken down) may be used. In breast fed babies the mother can try a cow’s milk exclusion diet with appropriate calcium supplements.
- In very severe cases of GORD, where medical treatment is ineffective, anti-reflux surgery may be required.
Weaning
Babies that do experience reflux may also have difficulties when weaning onto solid food. These babies may find it difficult to progress from pureed foods to lumpier textures and finger foods. If this does happen it is important that appropriate help and guidance is sought from a Health Professional.