GERD Symptoms in Newborns

GERD, or gastroesophageal reflux disease, can affect newborns as well as adults. When the symptoms are severe, aggressive treatment might be necessary. The condition is common and definitely a bit messy. Know the symptoms of GERD in infants, when it's normal, and when to seek treatment.

History

The exact reason you have a burp cloth is because most babies have some reflux or spit up. According to National Digestive Diseases Information Clearinghouse, half of all infants experience some GERD in the first three months. Every mother knows it can happen after feeding, crying, straining or coughing. It doesn't seem to bother them a bit as they spit, smile, play and cuddle. In a few cases, treatment might be needed.

Significance

If your baby fails to gain weight, won't eat, spits up forcefully and in large amounts (greater than a tablespoon at a time), or is irritable during or after feedings, you can suspect GERD might be a problem requiring a medical evaluation. nfants who project, or produce green or brown fluids, are lethargic or have diarrhea or other illness need immediate medical care. GERD can be caused by constriction of the pyloric valve that allows the stomach to empty (pyloric stenosis), though it is rare. Normal GERD does not interefere with your infant's growth or feelings of well-being.

Identification

Identifying GERD as normal involves watching for warning signs. Pain, fever, and difficulty breathing are conditions associated with GERD that warrant medical treatment. Symptoms also include improvement when your baby is upright. If symptoms persist, try feeding the baby slower with more frequent, smaller amounts. Arching of the back and wheezing without evidence of spitting up can be symptoms of "silent" GERD. Any adult who has suffered knows the discomfort associated with reflux.
Testing from you doctor might include basic blood tests to look for viruses and infection, stomach x-rays, including a barium swallow, or monitoring of stomach PH during hospitalization. Upper endoscopy is more invasive, involving passage of a tube to look for structural abnormalities, such as strictures that promote GERD and may require surgical intervention.

Prevention/Solution

Preventing the problem entirely is almost impossibe because your baby just isn't fully developed and some stomach contents inevitably will slip upwards from the stomach and out their mouths. In most cases, GERD will resolve on it's own.
Keeping your baby calm by feeding before they pass the point of no return helps them eat more slowly and swallow less air. Feed an ounce at a time and if you breastfeed, try limiting to one breast. It might help to elevate the head of the crib sightly.
The size of the bottle nipple is important if your baby is gulping. Incorrect nipple size literally pours too much too fast into a little tummy. Discover the value of burping, but if your baby spit's up too frequently, you might need to take time to allow a few more burps. With your doctor's approval, rice cereal can thicken milk, slowing down the feeding process. A bit of cereal also might be just what your baby needs to feel satisfied and less frantic with eating. Allow your baby to sit up longer after eating, avoiding overactivity, such as tickling and jiggling for at least 30 minutes until the stomach contents can settle

Effects

Some researchers say that frequent bouts of infant GERD can lead to childhood episodes. In most cases, you can expect little or no complications. Again, speak with your doctor if symptoms are severe or otherwise causing concern.

Resources

• Infant GERD