GERD in Children

GERD is not an uncommon disorder amongst infants but this diagnosis is frequently missed out due to the fact that spitting up after a meal is a common occurrence in children. However, this is a difference between spitting up after a meal and the symptoms of GERD. If the parents are able to observe that their infant possibly has symptoms that are not normal, they will seek treatment well in time.

GERD causes upward movement of the contents of the stomach (food+acid) into the food pipe (esophagus) of the child, sometimes into or out of the mouth.

Causes of GERD in children:

A poorly coordinated gastrointestinal tract is the commonest cause of GERD in children. An immature digestive system is a prime reason for this complaint and this is precisely why most infants outgrow this condition by the time they complete 1 year of age. The causes of GERD in older children are predominantly the same as the causes of GERD in adults.

Certain other factors that may contribute to GERD include obesity, overfeeding, certain medications, etc. There also appears to be an inherited component to GERD, as it is more common in some families than in others.

Symptoms of GERD in children:

The common symptoms of GERD in children are as follows:

  • Recurrent vomiting
  • A frequent or persistent cough
  • Refusing feeds or notable difficulty in eating
  • Choking or gagging during feeds
  • Older children may complain of heartburn, abdominal pain, or gas
  • Infants may demonstrate colicky behavior (frequent crying and fussiness).
  • Regurgitation and re-swallowing

Severe cases may lead to any of the following in the long run:

  • Poor growth
  • Breathing problems
  • Recurrent pneumonia

Consult your healthcare provider when the following occurs:

  • Large or persistent vomiting, particularly in infants under 2 months of age
  • Vomiting of fluid that is greenish or yellowish and appears like grounded coffee or blood
  • Difficult breathing is associated with vomiting or spitting up
  • Excessive irritability related to feeding
  • Weight loss or poor weight gain is associated with refusal to feed.
  • Difficult or painful swallowing

Diagnosis of GERD in children:

In most cases, the history given by the parents is sufficient enough to diagnose this condition. Repeated recurrence of the above-mentioned complaints and visible distress of the child are adequate for diagnosis.

However, the following tests can be conducted to confirm the diagnosis 

  • Upper GI endoscopy
  • Barium swallow
  • Gastric emptying study
  • Esophageal pH probe

Treatment of GERD in children:

Most babies outgrow GERD by the time they complete one year of age. However, even during this period, proper treatment must be administered to ensure that the complaints do not worsen. For children in whom this condition persists beyond one year of age, the treatment gives significant relief from distress and also controls the progress of the complaints. Click here to read about the Homeopathic treatment of GERD in children. Please note that the principles of treatment largely remain the same as in adults. However, certain additional lifestyle changes are suggested for infants for better control of the symptoms:

  • Elevate the head end of the baby's crib
  • Hold the baby upright for at least 30 minutes after a feed.
  • Burp feeding on each side.
  • Try several short feeds frequently rather than one large feed
  • With the approval of your doctor, introduce semi-solid foods into the diet of your infant
  • Avoid over-feeding the child at any time
  • Older children should not be allowed to lie down for at least 2 hours after meals
  • Limit foods that you think worsen your child's complaints

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Dr. Rajesh Shah

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