About gastro-oesophageal reflux and GORD
Gastro-oesophageal reflux is when food or milk from the stomach comes back up into the food pipe or mouth.
Reflux is very common in young babies because the muscles at the top of their stomachs aren’t strong enough to stop food or milk from going back up the food pipe. Reflux usually gets better with time as children start to eat solids, sit up for longer, and develop stronger stomach muscles.
Most babies who bring up milk are healthy. Reflux is usually nothing to be concerned about.
Rarely, babies might have complications from reflux. When this happens, it’s known as gastro-oesophageal reflux disease (GORD).
Symptoms of gastro-oesophageal reflux and GORD
If your child has gastro-oesophageal reflux, they’ll vomit up milk or food. This can happen during, between and after feeds.
Reflux usually doesn’t cause babies any pain or problems with weight gain.
But if your child has gastro-oesophageal reflux disease (GORD), they might vomit frequently and also have symptoms like:
- choking, coughing or wheezing during feeds
- blood in their vomit
- distress during feeds
- refusal to feed
- poor weight gain or weight loss.
Vomiting is a key symptom of reflux. If your child isn’t vomiting but cries a lot, pulls up their legs or knees, or arches their back, it’s best to see your GP, paediatrician or child and family health nurse. They can rule out other medical causes and help you with settling strategies.
Medical help: when to get it for children with gastro-oesophageal reflux and GORD
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 they have blood in their vomit or their vomit is green.
If your child has severe gastro-oesophageal reflux disease (GORD), your GP or the emergency doctor might refer you to a gastroenterologist.
Tests for gastro-oesophageal reflux and GORD
Usually, your child won’t need any tests for reflux.
If your child has severe gastro-oesophageal reflux disease (GORD), a gastroenterologist might do a gastroscopy. This procedure involves using a flexible tube to look at the structure and lining of your child’s food pipe and stomach. It’s done under a general anaesthetic.
The gastroenterologist might sometimes recommend pH monitoring to check whether there’s too much acid entering your child’s food pipe. This is done by placing a tiny tube with a sensor into your child’s food pipe for 24 hours. This might feel a bit uncomfortable, but it shouldn’t be painful.
Treatment for gastro-oesophageal reflux and GORD
Most cases of gastro-oesophageal reflux get better by themselves with time and don’t need treatment. But there are a few things that might help in the meantime.
You could try keeping your child upright for 15-20 minutes after a feed to ease the problem.
Your doctor might suggest thickening breastmilk or formula until the reflux gets better. Thickeners should be used only in consultation with your doctor. Your doctor will monitor your baby while you’re using thickeners.
If your child has gastro-oesophageal reflux disease (GORD), sometimes your doctor might recommend over-the-counter or prescription medicines to reduce your child’s symptoms. You’ll probably have a follow-up appointment with your doctor to check how your child is going with the medicine and whether they need to continue having it.
It’s always best to talk to your doctor or child and family health nurse before changing your child’s formula.
You should follow safe sleeping practices, even if your baby has reflux. This means putting your baby on their back to sleep on a firm, flat and level surface.