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Does Your Baby Have Gastroesophageal Reflux (GERD)

Katlyn Joy |15, November 2013


Spitting up is a normal event in infancy, but it can become something more troublesome. If your baby spits up an unusual and abnormal amount, GER and GERD very well may be the culprit.

What is the Difference Between GER and GERD?

GER or gastroesophageal reflux is when the contents of the stomach back up into the esophagus. Another name for the condition is acid reflux because much of what gets backed up is stomach acid. GER occurs because the muscle located between the esophagus and stomach, the esophageal sphincter, is not fully developed and stomach contents flows backwards producing spit up. GERD, or Gastroesophageal Reflux Disease, is a more serious condition that occurs when the sphincter muscle becomes weak allowing food and stomach acids to back up.

Symptoms of Gastroesophageal Reflux (GER)

  • Frequent spitting up or vomiting.
  • Fussiness during or after feeding.
  • Sleeping difficulties
  • Hiccups
  • Gagging or choking.
  • Wheezing or coughing.
  • Crying.

Symptoms of Gastroesophageal Reflux Disease (GERD)

  • Gagging.
  • Wheezing.
  • Vomiting.
  • Coughing.
  • Irritability especially once the tummy is full.
  • Arching of the back during or immediately following eating.
  • Respiratory problems such as trouble breathing or even pneumonia.
  • Difficulty feeding or refusing feedings.
  • Colic.
  • Trouble sleeping.
  • Poor growth.
  • Inability to gain weight or losing weight.

When to Call the Doctor

It can be hard to know when to call the doctor because anytime your baby is crying and miserable it rates as an emergency to a parent. However, there are definite signs that warrant a doctor's visit if you suspect GERD.

  • Your baby isn't gaining weight.
  • You see blood in your baby's bowel movements.
  • Violent spitting up or forceful vomiting.
  • Green or yellow spit up, or spit up that looks like coffee grounds.
  • Respiratory problems.
  • Refusing feedings.
  • Your baby is extremely fussy and crying.

What to Expect at a Doctor's Visit

According to the Mayo Clinic to determine whether your infant has GERD, the physician will most likely order tests such as:

  • Lab tests, including blood and urine tests.
  • Ultrasound to determine to look for obstructions in the stomach region.
  • Upper GI series.
  • Upper endoscopy.
  • Esophageal pH monitoring.

Some of these tests are simple and done in office, while others will require your baby to be under anesthesia. Before getting any procedure done, ask your pediatrician what the test is for, how it will be done, what complications could occur during and after the test. Also, be sure to ask how soon the results will be known.

Infant GERD Treatment Options

Generally most options for treatment include feeding changes or medication. Surgery is only required in rare and serious cases. According to the National Digestive Diseases Information Clearinghouse the following feeding changes are typical:

  • Burping your baby after 1 to 2 ounces of formula, or after nursing on each side.
  • Add a tablespoon of rice cereal to every 2 ounces of formula. You may need to enlarge the hole in the bottle's nipple.
  • For nurslings, add rice cereal to expressed milk.
  • Keep your baby upright for at least 30 minutes after feedings.
  • Do not overfeed your baby. Get directions from the pediatrician on how much is enough.
  • Consider a special formula that is pre-digested. Your doctor can give you more info and advice on this.

If lifestyle options and feeding changes do not relieve the serious symptoms of GERD, medications such as H2 Blockers or PPI's, proton pump inhibitors will be tried to relieve symptoms.

Coping Strategies for Parents

Having a baby that is regularly miserable, clothes that reek of vomit and stained blankets and tops is tiring and frustrating, on top of the other demands of raising a baby. Here are some ways to help yourself survive this difficult period.

Make sleep a priority.
Find a way to nap whenever possible. Maybe alternate night time duties with your spouse. Sleep deprivation will make everything harder.

Follow a consistent feeding schedule.
Get the details down cold from your baby's pediatrician and follow them faithfully.

Make sure your baby is as comfortable as possible.
Don't allow your baby to wear tight clothing – especially around the waistband.

Get support.
Finding someone to talk to and have someone you can call to help you out with your baby. Ask for a break when you need one. This is no time to be the lone ranger.

Make time for yourself and for your spouse.
Make it a goal to have 30 minutes to do something you enjoy each day, and make it a priority to spend at least one evening per week alone with your partner.

Know that this won't last forever.
Remember, this will pass. Your baby will get better and will be happy, sleeping and growing!

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