How to treat heartburn, reflux in babies and children
Heartburn and reflux is very common in children of all ages, but that doesn’t mean it shouldn’t be taken seriously. Left untreated, it may impact the growth and healthy development of your little one.
“Most normal, healthy babies spit up some milk after feeds. This is called posseting,” writes Marie-Louise Steyn in Breastfeed your baby (Meitz Press, 2013). “As long as your baby shows no other signs of illness, and as long as they have enough wet and soiled nappies and are growing satisfactorily, posseting is a laundry problem rather than a medical problem.”
Reflux, however, is not the same as posseting, Steyn says. As is the case with adults, reflux occurs when the lower oesophageal sphincter (LES), the valve-like structure between the baby’s stomach and oesophagus, doesn’t close properly and stomach acid flows back up into the oesophagus.
Usually, it’s a relatively harmless occurrence that improves with age, and as babies start to eat solid foods and spend more time upright.
But in some babies (especially pre-term infants), reflux can be severe and cause significant heartburn and discomfort – a condition called gastro-oesophageal reflux disease (GORD). This may lead to weight loss, anaemia, failure to thrive, coughing, frequent ear infections, pauses in breathing, and inflammation of the oesophagus. Reflux has also been implicated in sudden infant death syndrome (SIDS), so it may even be life-threatening.
Steyn advises consulting a paediatrician if:
- Your baby regularly chokes or coughs after feeds.
- Doesn’t gain weight satisfactorily.
- Arches their back in an attempt to ease heartburn.
- Cries inconsolably for long periods of time.
- Regularly fusses at your breast or refuses it completely.
Steps that may help include using a pacifier (the production of saliva may help to neutralise stomach acid), feeding your baby in an upright position, and elevating the head of your baby’s cot, so that gravity can assist in clearing the oesophagus of stomach acid.
Unfortunately, the Cochrane Institute found very little evidence that medication helps to alleviate heartburn in babies. Some research studies do, however, support the use of Gaviscon Infant. Talk to your doctor about the best possible solution.
Toddlers and young children
Although heartburn and reflux tend to disappear with age, some children continue to experience it. Once again, this may be an indication of GORD.
Toddlers and children with GORD are more likely to report a general tummy upset than the symptoms typically experienced by adults (e.g. pain in the chest area and a bitter, sour taste in the mouth). Children are also more likely to vomit or regurgitate, and might experience ear-nose-and-throat as well as dental problems. Sometimes, younger children can’t express what’s bothering them, so they may become irritable and refuse to eat.
It’s important to check in with your paediatrician if your child experiences any of the above signs. Encourage your child to describe exactly what they’re feeling, so that you can translate this to your doctor.
Apart from making some practical changes (e.g. elevating the head of your child’s bed), medication in the form of a proton pump inhibitor or an H2 receptor antagonist may help.
Steyn, M. (2013) Breastfeed your baby – Make it easy and enjoyable for both of you. Meitz Press. ISBN: 978-1-9-920479-70-1.
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