Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) (Child)

Symptoms | Treatments

What is

What is - Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) (Child)

Gastroesophageal Reflux (GER)

Reflux occurs when there is a backflow of stomach contents into the throat and oesophagus (food pipe). Reflux is common in infants and symptoms include vomiting or frequent regurgitation (spitting up of milk) after feeding.

As infants mature and gain better muscle tone of their lower oesophageal sphincter (a ring of muscle at the end of the food pipe), the symptoms of reflux usually resolve by the age of 6 months.

Gastroesophageal Reflux Disease (GERD)

This is a less common and more severe form of reflux, resulting in inflammation of the oesophagus. Some infants are at a higher risk of developing GERD. This include infants who are born premature and infants with underlying neuromuscular disorders (nerve/muscle problems).

Besides having frequent regurgitation and vomiting, infants with GERD may have the following symptoms:

Poor weight gain or weight loss
Fussy and irritable during or after feeding
Frequent back arching because of discomfort
Milk refusal or poor feeding

Management of Infants with GER or GERD

Adequate Burping
Burp the infant well in the middle of feeding and after feeding.
Proper positioning
After feeding, caregivers can carry the infant in an upright position. You can also support and place the infant’s head and upper chest higher than the level of his stomach to keep the milk feeds in the stomach. This can be done by placing the infant’s head and upper back on a small pillow (or folded towels).
Avoid Overfeeding
Overfeeding may distend the stomach and increase the risk of reflux. Please consult your friendly healthcare providers for your child’s recommended milk feed volume and frequency. A smaller volume of milk feeds, given at more frequent intervals may be recommended to reduce reflux symptoms.
Trial of Anti-reflux formula milk.
Your child’s physician may recommend a trial of anti-reflux formula (thickened formula milk) to reduce the frequency of reflux symptoms.

Investigations and treatment of GERD

Diagnostic tests include 24-hour pH impedance monitoring and upper gastrointestinal contrast study. These tests may be recommended after consultation with the gastroenterologist.

Anti-reflux medications may be prescribed for infants with persistent reflux symptoms. These medications help to reduce gastric acid production (e.g. omeprazole) and increase gut movement (e.g. Domperidone). These medications are administered 30-60mins before milk feeds for optimal effect.

In severe and complicated cases of GERD, surgical procedures may be required.

Follow-up Appointment

A follow-up appointment may be warranted to review your child’s reflux symptoms, growth, and development. Please keep to the follow up appointment as advised by your friendly doctors.