Regurgitation of the stomach contents caused by immaturity and weakness of the muscles around the stomach’s entrance
- Most common under 1 year of age
- Gender, genetics, and lifestyle are not significant factors
Most babies bring up small amounts of milk after a feed. This regurgitation is normal and does not usually cause distress. However, if an infant regurgitates larger amounts of milk or food regularly, the cause may be gastro-oesophageal reflux disease (GORD). This condition occurs because the muscles at the entrance of a baby’s stomach are not fully developed. As a result, the contents of the stomach, including acidic digestive juices, are able to pass back up the oesophagus (the tube between the throat and the stomach). GORD is more common in premature babies and those with cerebral palsy, who have poor overall muscle tone.
What are the symptoms?
The symptoms of GORD are most noticeable after a feed and may include the following:
Regurgitation of milk, usually more pronounced when the baby is lying flat or is crying.
Coughing or wheezing if regurgitated milk is inhaled into the lungs.
If GORD is severe, it may prevent the baby gaining weight. Severe reflux may also cause inflammation and bleeding of the lining of the oesophagus, which may make the vomit bloodstained. Sometimes, if milk is inhaled into the lungs, a chest infection, such as pneumonia, may develop. Rarely, a baby can stop breathing temporarily after inhaling milk.
If your baby regularly regurgitates more than a dribble of milk after feeding or if the vomit is bloodstained, contact a doctor as soon as possible.
How is it diagnosed?
The doctor may be able to diagnose the condition from your baby’s symptoms. However, if he or she is unsure of the diagnosis, a test may be carried out to monitor the amount of acid passing up the oesophagus from the stomach over 24 hours. This test involves passing a narrow tube into the baby’s nose and down the oesophagus. The doctor may arrange for further tests, including a specialized X-ray (see Barium swallow), to check for a structural abnormality in the oesophagus. If a baby has severe reflux with bloodstained vomit, endoscopy (see Upper digestive tract endoscopy) may be carried out to look for inflammation of the lining of the oesophagus.
What is the treatment?
In most cases, small, frequent feeds help to prevent GORD. Raising the head end of the cot after giving feeds may also help to prevent regurgitation. The doctor may prescribe a thickener or antacids to be added to your baby’s milk. In more severe cases, drugs may be given to lower the production of acid in the stomach (see Ulcer-healing drugs). With appropriate treatment, symptoms usually improve. Most babies outgrow GORD by the age of about 1 year. In the rare cases that do not clear up by themselves, surgery may be recommended.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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