Reflux in infants: When to see a doctor?

The article was consulted with Master, Doctor Nguyen Thi An - Pediatrician - Neonatologist - Department of Pediatrics - Neonatology - Vinmec Ha Long International General Hospital.

Infant reflux often occurs several times a day, even for healthy babies. This is a common condition in young children, is not dangerous and will subside as the baby gets older.

Reflux in children occurs when food flows back up from the stomach into the esophagus, causing the baby to spit up or vomit. You can rest assured if your baby is still gaining weight and developing normally despite frequent reflux. This common and not very dangerous symptom is called acid reflux (GER), which is caused by too much stomach acid pushing up to irritate your baby's throat or esophagus. Usually, this condition is not a sign of a medical condition, such as allergies or a blockage in the digestive system.

Most babies under 1 year of age have reflux that will clear up on its own by the time your baby is a toddler. However, if your baby continues to have reflux after 18 months of age, it could be a sign of something more serious, gastroesophageal reflux disease (GERD). Gastroesophageal reflux disease (GERD) is a rare and dangerous complication of acid reflux (GER).
Some studies show that babies who spit up frequently may be more prone to GERD. The difference between GER and GERD is in the severity and duration of the effects, but both symptoms are treatable.

The ring of muscle between the esophagus and stomach, also known as the lower esophageal sphincter (LES), is responsible for keeping food in the stomach. The mechanism of action of this muscle ring is to always close tightly and only open when we swallow. In infants, the lower esophageal sphincter (LES) is not yet fully developed to perform its full function. In addition, the digestive system of the baby is still weak and this is the reason why the baby is more prone to reflux.

Some other factors that can contribute to common infant regurgitation are:
Baby often lies on his back A diet that's mostly liquid The baby was born prematurely.

Sometimes, infant reflux can be a sign of more serious conditions, such as:
Gastroesophageal reflux disease (GERD): In older children, causes of GERD include: obesity, eating too many spicy or greasy foods, drinking carbonated or caffeinated soft drinks, taking certain medications, or genetics. Pyloric stenosis: The pylorus is a valve located between the stomach and small intestine. When it is narrowed, it will prevent the contents of the stomach from entering the small intestine, making it difficult for the digestive system to function. Food intolerance: The body's response to certain foods, of which a protein found in cow's milk is the most common. Allergic esophagitis: This is a rare disease, also known as eosinophilic esophagitis. The white blood cells (eosinophil) of the patient accumulate a lot and cause damage to the lining of the esophagus.

In general, reflux in children is not a cause for concern for parents. However, you should pay attention if your baby has the following symptoms:
Poor growth, not gaining weight Severe vomiting, accompanied by strong abdominal muscle spasms Spitting green or yellow liquid. Sometimes a thick consistency that looks like coffee grounds and has blood The baby refuses to feed or eat There is blood in the baby's stools Baby has trouble breathing or has a long, persistent cough Starts vomiting 6 months or older Irritability, crying abnormality when eating or right after eating Heartburn or stomach pain Sore mouth, especially in the morning Recurrent pneumonia The above symptoms can be the cause of other more serious conditions such as acid reflux gastroesophageal reflux disease (GERD) or gastrointestinal obstruction. Take your child to the hospital early for timely diagnosis and treatment.

Usually, your doctor will diagnose acid reflux based on the symptoms you describe and your baby's medical history. Your child may need testing sometimes, especially if the problem is frequent and bothersome.

Here are some reference measures that you can take at home to help ease your baby's reflux:
Elevate the head of your baby's bed, crib or bassinet about 30 degrees Hold your baby standing for 30 minutes after feeding, yes can combine patting back to support baby burping Pay attention to limit foods and drinks that make your baby prone to reflux should not be too large to avoid strong milk flow Split meals during the day, increase the number of feedings and reduce the amount of food per feeding Support your baby with simple exercises In addition, can thicken your food baby by adding cereal to the bottle. However, you should consult your doctor before using this method. If the reflux becomes severe or does not improve, doctors may prescribe several appropriate medications. Most medicines that help your child's stomach make less acid and gas are safe. Some side effects, such as diarrhea, may occur if taken in high doses. In cases where high doses of the drug must be used for a long time, children are at risk of developing osteoporosis, known as rickets, or vitamin B12 deficiency.

Reflux in babies will usually go away on its own without causing any negative problems for your baby. However, if your child has a more serious condition such as GERD, there is a greater risk that he will grow poorly. Sometimes surgery is needed to completely cure the disease if the baby still has respiratory problems or pneumonia.

Reference source: Mayoclinic.org