Babies get heartburn tooAcid reflux is thought to affect twenty per cent of all babies but what exactly is it and how is it treated? If your baby has gastro-oesophageal reflux disease and you wonder if the crying and vomiting will ever stop, here are some strategies to help you cope.
Reflux simply means liquid flowing in the wrong direction. In babies with acid reflux or gastro-oesophageal reflux (GOR) acid from your baby's stomach is being squirted back up his oesophagus (food pipe). The oesophagus is a tube that carries food and drink from your mouth to your stomach. At the end of the oesophagus is a valve that opens to let the food enter the stomach then closes again. It is thought that in babies with GOR, this feeding system is still immature and the valve is not toned enough to stay shut, therefore allowing the food to go back up the food pipe and sometimes come out as vomit. The condition is more common in premature babies and also in babies whose parents smoke, due to the effects of passive smoking. It is less common in breastfed babies as breast milk is more easily and more quickly digested. Up to 80 per cent of babies are born with some degree of reflux due to immaturity of the valve but fortunately most of these will not have any symptoms and will have totally outgrown it by 12 months old. However, for some babies the problem persists and symptoms vary depending on the severity of the reflux. Symptoms usually start between two and four weeks old and include:
Often, a doctor will diagnose reflux after listening to your account of your baby's symptoms. Sometimes, in a minority of cases, some further tests can be done to confirm the diagnosis.
Most babies with reflux will not have any of these tests. For the babies who need treatment, simple medication can be prescribed. Dr Jo lee says, "The usual treatment for reflux is Gaviscon, either in or around the time of feeds. There are several other types of medication, such as H2 receptor antagonists or motility stimulants that may be helpful in controlling reflux symptoms but these are usually avoided if the baby is thriving." H2 receptors reduce the amount of acid produced in the stomach but are only used in severe cases. However, there are things that you can do to help your baby. Roni Maclean, author of Life on the Reflux Rollercoaster, suggests several methods which will ease the symptoms of reflux. Positions during and after feeds Breastfeed if possible Thickening Feeds Raise cot heads while sleeping Carry baby as much as possible Use a dummy Baby massage Natasha's son Ellis was diagnosed with gastro-oesophageal reflux when he was 13 weeks old, after weeks of severe vomiting and losing weight. "Ellis would scream and cry and be constantly irritable and there were times when I felt incredibly helpless. My instincts as a mother were to ease his pain but I couldn't. "After he was diagnosed I thought things would improve but they didn't. I think this was the worse time." Natasha admits that her marriage to husband Graham became very strained with the constant demands of dealing with a reflux baby. "Ellis often would only let me feed him and I became resentful that he was taking up all my time while Graham could get a break from it all. Childcare was impossible because he was so high maintenance with his constant vomiting "I became desperate for a break and realised that I had to grab every opportunity I could, even if that meant leaving Ellis crying with Graham while I locked myself away." Eventually, when he was 6 months old Ellis needed a procedure called a Nissen's Fundoplication, an operation which involves wrapping the top of the stomach around the bottom of the oesophagus. This is only done as a very last resort in extreme cases of GOR and has a high complications rate. Natasha says allowing the procedure was the hardest choice she ever made. "He had the operation on Bonfire night and I stood at the window watching the fireworks and crying my eyes out. But I wanted to enjoy my baby and I wanted him to be out of pain so the operation was the only way forward." Ellis is now a thriving six year old who is taller than most of school friends. Natasha says, "His appetite is still not brilliant and he'll never be overweight but he leads a normal healthy life. His operation means he'll never be able to vomit which is something he'll have to be careful about when he's older but I'm just glad we came through it." Her advice to other parents is simple. "Make time for yourself, no matter when it is. Sleep when your baby sleeps and educate friends and relatives so they understand the problems. And most importantly, never blame yourself. It's easy to feel guilty but nothing you did during pregnancy caused the reflux." Because most cases of reflux are caused by an immaturity of the sphincter muscle at the stomach, most children will outgrow their reflux within the first few months and by twelve to eighteen months, nearly all babies have outgrown it. Sometimes, it may seem that your baby starts to get better then relapses. This is common and can often be due to a certain food disagreeing with him, or in response to a virus such as a cough or cold. Despite this, these episodes do pass again and become less frequent over time. For a small number of children, especially those with motor diseases, reflux may continue into childhood. Where to next?
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