What is gastro-oesophageal reflux?
Gastro-oesophageal reflux is when your child brings the contents of his stomach back up into his food pipe or mouth.
It happens when the muscles between your baby’s food pipe (oesophagus) and tummy relax for a moment because they’re not fully developed.
This results in a type of vomiting or spitting called ‘posseting’.
Symptoms of gastro-oesophageal reflux
If your baby has gastro-oesophageal reflux, she might vomit milk. This can happen during, between and after feeds.
You’ll usually see reflux symptoms within the first month after birth.
Most children with reflux grow out of it by the time they’re toddlers. This is probably because they’re spending more time in an upright position by this age. They’re also eating more solid foods.
A few children keep having symptoms after the toddler period.
Gastro-oesophageal reflux disease (GORD)
In some babies and children, reflux very occasionally leads to complications. In this case, your doctor might diagnose your child with gastro-oesophageal reflux disease (GORD).
GORD symptoms include pain and discomfort in the chest or stomach, which might make your baby cranky. Your baby might cry a lot or arch his back.
If your baby has GORD, she might have:
- disrupted sleep
- poor weight gain
- a chronic cough and wheeze
- blood in her vomit.
Does your child need to see a doctor about gastro-oesophageal reflux?
You should see your GP if your child:
- finds it difficult to swallow
- has a fever
- is irritable and difficult to settle a lot of the time
- won’t eat
- is vomiting a lot
- isn’t growing properly or is losing weight
- has a chronic cough or recurrent chest infections.
Take your child to a hospital emergency department if he has green fluid or blood in his vomit.
Tests for gastro-oesophageal reflux
Usually, your child won’t need to have any tests for reflux.
If your child has reflux complications or GORD, sometimes your doctor might recommend pH monitoring (checking acid levels) to see whether there’s too much acid in her food pipe. This is done by placing a tiny tube with a sensor in your child’s food pipe for 24 hours.
Sometimes your doctor might also want to look at the lining of your child’s food pipe using a special camera. This test is called an endoscopy and is done under a general anaesthetic.
Treatment for gastro-oesophageal reflux
Most cases of gastro-oesophageal reflux get better by themselves with time and don’t need treatment.
If your baby’s reflux is mild, and his weight gain isn’t affected, you could try feeding him in a more upright position to ease the problem. Try keeping him upright for about 30 minutes after feeds.
Your doctor might suggest thickening breastmilk with rice cereal or a thickening agent until symptoms resolve. If your baby is formula fed, your doctor might recommend thickening your baby’s formula or using prethickened formula. If you’re worried about your baby’s weight gain while your baby is using thickeners, talk to your doctor.
If your child seems to be in pain after vomiting, or isn’t gaining enough weight, your doctor might prescribe an acid suppressant.
You should follow safe sleeping practices, even if your baby has reflux. This means putting your baby on her back to sleep. She should sleep on a firm, flat mattress that isn’t elevated in any way.