Infant acid reflux is frequently considered a temporary condition where the contents of a baby's upper digestive system reflux, or back up, causing him or her to spit up. Prompted by a variety of activities that may place stress on the esophagus, such as crying or coughing, infant acid reflux commonly subsides within the first year of life. Treatment for infant acid reflux is usually centered on symptom management, which may involve dietary and feeding accommodations. Rarely does this condition require the administration of additional treatment, such as the use of medications or surgery.
Nearly all infants experience some presentation of acid reflux during the first few months of life because their digestive systems are still developing and adjusting after birth. Eating too quickly or swallowing air often contribute to the occurrence of reflux in many infants since their lower esophageal sphincter (LES) is still maturing. The LES, when fully matured, essentially works as a gatekeeper, controlling the passage of substances from the esophagus into the upper digestive tract.
A diagnosis of acid reflux is generally made through an examination of the infant and evaluation of his or her symptoms. Additional testing is usually ordered if the infant’s symptoms indicate the presence of a more serious condition, such as gastroesophageal reflux disease, or GERD. Testing may consist of an endoscopic evaluation of the infant's upper digestive tract, blood and urine analysis, and imaging testing, often including barium-assisted X-rays.
Infants who experience acid reflux may demonstrate a variety of signs and symptoms. Though spitting up is the most common manifestation of acid reflux, infants may also develop pronounced mood swings that occur in the vicinity of scheduled feeding times, often presenting as irritability or fussiness. In some cases, an infant’s appetite may also become reduced or otherwise impaired due to his or her resistance to feeding. Additional signs of reflux, including gagging, coughing, and vomiting, may occur during or following a feeding. A progression of symptoms that results in lethargy, greenish or brown saliva discoloration, or impaired growth should prompt a visit to a physician so that the infant’s condition and overall health may be evaluated.
When infant acid reflux worsens or does not subside independently, treatment may include the implementation of dietary and feeding changes. Women who are nursing may be advised to make dietary changes to aid with reducing their infant's episodes of reflux. Often, parents may be instructed to adjust the frequency and duration of their infant’s feedings. Re-positioning the infant during the feedings, such as sitting upright versus reclined, and altering the type of formula administered may also help alleviate symptoms. If the infant does not respond to such changes, more extensive treatment may be necessary.
In rare cases, medication may be prescribed to alleviate any reflux-induced discomfort an infant may experience. The failure of traditional treatments and medications to alleviate severe symptoms that jeopardize the overall health of the infant may necessitate surgery to tighten the LES, a procedure known as fundoplication. The procedure does carry significant risks, which should be discussed with a qualified pediatrician or health care provider. If left untreated, persistent cases of infant acid reflux that remain into the child’s second and third years may result in the development of GERD during childhood.
