Materiały źródłowe

• #1 Reflux in babies

  https://www.nhs.uk/conditions/reflux-in-babies/

  Reflux is when a baby brings up milk, or is sick, during or shortly after feeding. It’s very common and usually gets better on its own. […] Your baby does not usually need to see a doctor if they have reflux, as long as they’re happy, healthy and gaining weight. […] A GP or specialist may sometimes recommend treatments for reflux. […] If your baby is formula-fed, you may be given: a powder that’s mixed with formula to thicken it, a pre-thickened formula milk. […] If the thickening powder does not help or your baby is breastfed, a GP or specialist might recommend medicines that stop your baby’s stomach producing as much acid. […] Very rarely, surgery might be needed to strengthen the muscles to stop food or milk travelling back up. This is usually only after trying other things or if their reflux is severe.

• #1 Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1015/p705.html

  Gastroesophageal reflux in infants may be treated with body position changes while awake, lower-volume feedings, thickening agents (i.e., rice cereal), antiregurgitant formula, extensively hydrolyzed or amino acid formulas, and, in breastfed infants, eliminating cow’s milk and eggs from the mother’s diet. […] Histamine H2 receptor antagonists and proton pump inhibitors are the principal medical therapies for GERD. They are effective in infants, based on low-quality evidence, and in children and adolescents, based on low- to moderate-quality evidence. […] Conservative treatments are the first-line strategies for most infants, older children, and adolescents with reflux and GERD. […] A trial of extensively hydrolyzed or amino acid formula in formula-fed infants, or maternal dietary modification in breastfed infants, is warranted when reflux is presumed to be caused by an allergy to cow’s milk protein.

• #1 Treatment of GE Reflux – Department of Pediatrics

  https://med.virginia.edu/pediatrics/clinical-and-patient-services/patient-tutorials/about-gastroesophageal-ge-reflux/treatment-of-ge-reflux/

  The most important thing to remember when treating gastroesophageal (GE) reflux is that in almost all cases, the problem will get better on its own! […] Given enough time, the baby will fix the problem on his or her own. […] Treatments for reflux can be summarized in categories: positioning, dietary treatments, changing feeding schedules, medications, surgery. […] Theoretically, the best position to but a baby with reflux in after meals is lying on the stomach with the head propped up about 30 degrees. […] Young infants don’t have much control of their abdominal or chest muscles, so when placed in an infant seat or swing, they tend to slump down. […] Parents may be instructed to thicken infant feedings with cereal. […] Many parents find that their babies keep solid foods down more effectively than liquids.

• #1 Treatment of GE Reflux – Department of Pediatrics

  https://med.virginia.edu/pediatrics/clinical-and-patient-services/patient-tutorials/about-gastroesophageal-ge-reflux/treatment-of-ge-reflux/

  Parents are sometimes instructed to feed their babies smaller amounts more often with the idea that over-feeding tends to make reflux worse. […] Most medications used to treat reflux fall into three groups based on how they work: break down or lessen intestinal gas, decrease or neutralize stomach acid, improve intestinal coordination. […] It is assumed that decreasing the amount of stomach acid will lessen reflux symptoms. […] For the most part, medicines that decrease intestinal gas or neutralize stomach acid (antacids) are very safe. […] Side effects from medications that inhibit the production of stomach acid are uncommon. […] Reglan increases the pressure of the lower esophageal sphincter (LES) and helps the stomach empty more quickly. […] It is extremely rare for children with GE reflux to require surgery. […] The most commonly performed operation is the Nissen fundoplication. […] This operation is very effective at eliminating GE reflux, with long-term success rates approaching 90%.

• #1 Treating Acid Reflux in Infants

  https://www.healthline.com/health/gerd/infants-treatment

  Whether youre nursing or bottle-feeding, make sure to frequently burp your baby. Burping your infant during a feeding may help with reflux symptoms. […] If lifestyle changes dont help, your pediatrician may recommend further investigation into other causes of your babys symptoms, such as GERD. […] Although people frequently use medications like omeprazole (Prilosec) for acid reflux treatment, studies havent shown that theyre effective. […] Talk with your doctor about which treatment plan based on the severity of the symptoms. They will recommend a medication that best suits your baby. […] Surgery may be necessary if medications and lifestyle adjustments dont help ease your babys symptoms. […] Acid reflux in an infant is a treatable condition. Finding the lifestyle changes that work for your little one will likely help ease their acid reflux. […] No matter what your babys symptoms, talk with your doctor about your concerns, so they can accurately diagnose the problem and help you find the best method to reduce your babys discomfort.

• #1 Reflux In Babies: What Parents Need To Know | Henry Ford Health – Detroit, MI

  https://www.henryford.com/blog/2020/11/reflux-in-babies

  Reflux is remarkably common among babies. In fact, more than half of all babies will have some level of reflux. […] Infant reflux happens when food backs up (refluxes) into the esophagus from the stomach. […] Babies with gastroesophageal reflux disease, or GERD, on the other hand, spit up frequently. They’re fussy, irritable and may arch their backs in pain. […] Most infants outgrow reflux by 18 months of age. However, if your child has GERD, they may experience respiratory symptoms including coughing and choking. […] Reflux tends to peak around four to six months and then improve. […] There are things parents and caregivers can do to help ease tummy troubles associated with reflux. Common strategies include: Burping frequently: Instead of waiting until your child reaches the end of the bottle, try burping after each ounce of milk or formula. Placing the child upright for feeding: You should never feed a baby while she’s lying down. Instead, make sure she’s at a 45-degree angle, which helps ensure milk flows down the esophagus and into her tummy. Keeping the child upright after eating: Wait at least 30 minutes after a meal before lying your baby down. That upright position will help the stomach do its job of digestion. Not overfeeding: Be careful not to overfeed your baby. When you’re boosting intake to meet your baby’s needs, be sure to increase the amount by only half an ounce to an ounce at a time. Thickening the milk or formula: In severe cases, your doctor may recommend thickening formula or breast milk with cereal.

• #1 Reflux in babies

  https://www2.hse.ie/conditions/reflux-babies/

  Reflux is where some of the milk and acid in your baby’s tummy leak back up into their mouth. This is different from vomiting. […] Most babies don’t need any treatment or any tests. […] Reflux normally improves as your baby gets older. 9 out of 10 babies with reflux are better by the time they are 1 year old. […] If your baby is breastfed, your GP might give you a powder to stop milk and acid from being brought back up into the food pipe. This powder is called alginates. […] If your baby is formula fed or combination fed, your GP or PHN may advise: smaller, more frequent feeds for your baby, while making sure your baby is getting enough formula daily; a pre-thickened formula mix; adding a powder called an alginate to your baby’s feed – this is to stop milk and acid from being brought back up their food pipe.

• #1 Gastro – Oesophageal Reflux – Alder Hey Children’s Hospital Trust

  https://www.alderhey.nhs.uk/conditions/patient-information-leaflets/gastro-oesophageal-reflux-2/

  Occasionally reflux can become problematic causing babies to become very distressed, refuse feeds and not gain weight as we would like. If this happens you may want to try a thickened formula, (also called Anti Reflux formula) as this can help keep the stomach contents down. […] Most babies do not need medication for Reflux and this should be avoided if possible. There is no evidence to suggest that medicines work for babies with reflux and all medications have side effects. Medications that are sometimes trialled for more severe reflux include: […] Omeprazole works by reducing the amount of acid produced in the stomach. However, we know that stomach acid is important for killing bacteria in the stomach and reducing the risk of infection. […] You should see a doctor if:- […] There are new concerns such as marked distress, feeding difficulties or faltering growth.

• #1 How to Treat Acid Reflux in Babies

  https://www.verywellhealth.com/treating-reflux-in-infants-2748615

  Holding your baby upright for about 30 minutes after each feeding can reduce reflux symptoms. […] If you suspect a food allergy is causing your baby’s reflux symptoms, talk to your provider about changing to a special infant formula, specifically you may need a hypoallergenic formula. […] If your baby is sensitive to cow’s milk protein (called cow’s milk protein intolerance or CMPI), they may have GI symptoms, including reflux. […] If your pediatrician thinks your baby’s reflux could be triggered by dairy, they may recommend switching to only breastfeeding or trying a dairy-free formula to see if your baby’s symptoms get better. […] If you’re breastfeeding, your baby can react to the foods you eat. […] Research has shown that thickening infant formula with powdered infant cereal may help reduce GERD symptoms in one to eight weeks.

• #1 How To Manage Infant Reflux | SMA HCP

  https://www.smahcp.co.uk/practical-support/feeding-issues/how-to-manage-infant-reflux

  In breastfed infants, if frequent regurgitation associated with marked distress continues despite a breastfeeding assessment, alginate therapy should be considered for a trial period of one to two weeks. If the alginate therapy is successful, it can continue to be used and stopped at frequent intervals to assess recovery. […] NICE guidelines state that a four-week trial of proton pump inhibitors (PPIs) or H2 receptor antagonists (H2RAs) can be considered for children and young people with persistent heartburn, retrosternal or epigastric pain. PPIs and H2RAs should not be used to treat overt regurgitation in infants and children occurring as an isolated symptom. […] Gastro-oesophageal reflux is a common condition in infants which often requires no further treatment other than parental reassurance. It is important that HCPs are able to recognise the signs and symptoms of GOR/GORD and implement the treatment pathway to manage it within the community and avoid unnecessary hospital admissions.

• #1 Reflux in Babies: Signs & Treatment

  https://my.clevelandclinic.org/health/diseases/reflux-in-babies

  Reflux in babies is common among babies in their first year and usually harmless. But it’s sometimes a sign of gastroesophageal reflux disease (GERD) or other conditions that need medical treatment. […] GERD refers to chronic acid reflux that may affect a person’s quality of life and damage their esophagus. Babies with GERD need closer monitoring and may benefit from treatment like medications. […] Treatment for your baby’s reflux depends on its severity. Babies with GER don’t need medications. Instead, they may benefit from changes to their feeding routine. Such changes can also help babies with GERD, but these babies sometimes need medications. Rarely, babies with GERD need surgery. […] Healthcare providers only prescribe medications for babies who clearly have GERD, and even then, only in select cases. Medications like proton pump inhibitors (PPIs) can help manage complications of GERD, like inflammation in your baby’s esophagus (esophagitis). But they come with risks and side effects, so providers use them only when necessary and for as short a time as possible. […] If other measures aren’t enough to treat GERD or its complications, surgery may be an option. A pediatric gastroenterologist can tell you more about surgical options, including laparoscopic Nissen fundoplication. Providers consider surgery in infants only in select cases.

• #1 Reflux in Infants: MedlinePlus

  https://medlineplus.gov/refluxininfants.html

  Feeding changes may help your baby’s reflux and GERD: […] If feeding changes do not help enough, the doctor may recommend medicines to treat GERD. The medicines work by lowering the amount of acid in your baby’s stomach. […] Medicines for GERD in babies include: H2 blockers, which decrease acid production […] Proton pump inhibitors (PPIs), which lower the amount of acid the stomach makes. […] If these don’t help and your baby still has severe symptoms, then surgery might be an option. Pediatric gastroenterologists only use surgery to treat GERD in babies in rare cases. They may suggest surgery when babies have severe breathing problems or have a physical problem that causes GERD symptoms.

• #1 Pediatric Gastroesophageal Reflux Treatment & Management: Approach Considerations, Positioning, Dietary Measures

  https://emedicine.medscape.com/article/930029-treatment

  Conservative measures in treating gastroesophageal reflux may include upright positioning after feeding, elevating the head of the bed, prone positioning (infants 6mo), and providing small, frequent feeds thickened with cereal. […] In more severe cases, in addition to dietary management, pharmacologic intervention directed at reducing gastric acid secretion can be employed. […] According to the guidelines of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, infants with uncomplicated physiologic GER should be treated not with medication but with modest lifestyle changes; medications should be reserved for infants with GERD. […] The most aggressive treatments, including surgery, should be reserved for children who have intractable symptoms or are at risk for life-threatening complications.

• #1 Treatment for GER & GERD in Children – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-children/treatment

  Doctors may recommend lifestyle changes or medicines to treat gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) in children. In some cases, doctors may also recommend surgery. […] Doctors may recommend lifestyle changes to reduce GER or GERD symptoms. […] Lifestyle changes your child’s doctor recommends may depend on your child’s age and symptoms. For example, doctors may recommend that children who have GERD sleep with their head elevated or sleep on their left side. […] If lifestyle changes don’t relieve your child’s GERD symptoms, your child’s doctor may prescribe medicines. […] Proton pump inhibitors (PPIs) lower the amount of acid the stomach makes. […] Doctors typically prescribe PPIs to treat GERD in children for 4 to 8 weeks. In some cases, doctors may prescribe PPIs for long-term treatment. […] Doctors may recommend surgery to treat GERD in children if medicines and lifestyle changes don’t improve symptoms or if serious GERD complications occur. […] Fundoplication is the most common surgery for GERD. In most cases, it leads to long-term improvement of GERD symptoms.

• #1 Infant reflux | Better Health Channel

  https://www.betterhealth.vic.gov.au/conditions-and-treatments/infant-reflux

  Taking medications for GORD means that babies may be at risk of the following compared to babies who do not take these medications: 3 to 6 times more likely to develop gastroenteritis (gastro) and pneumonia. […] Having a baby with reflux or who cries a lot can be challenging and worrying. Although there are no medications available, these strategies may help: Remember, if your baby is vomiting but is otherwise happy and growing well, there is no need to worry. […] Keeping your baby upright for 10 minutes after a feed may help. […] Use a diary to take note of how often your baby is crying and vomiting and when it is happening. That way you can keep an eye out for any changes and discuss any concerns with your doctor.

• #1 Infant reflux | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/infant-reflux

  For most babies, making some changes to feeding eases infant reflux until it gets better on its own. […] Reflux medicines aren’t typically used in children to treat reflux that isn’t complicated. But a healthcare professional may recommend an acid-blocking medicine for several weeks or months. Acid-blocking medicines include cimetidine (Tagamet HB), famotidine (Pepcid AC) and omeprazole magnesium (Prilosec). Your child’s health professional may recommend an acid-blocking medicine if your baby: […] Rarely, a baby may need surgery. This is only done if a baby is not gaining enough weight or has trouble breathing because of reflux. During the surgery, the LES between the esophagus and the stomach is tightened. This prevents acid from flowing back up into the esophagus.

• #1 Infant reflux | Better Health Channel

  https://www.betterhealth.vic.gov.au/conditions-and-treatments/infant-reflux

  Reflux is common in babies and causes no pain or problems with weight gain in most babies. […] Reflux medications do not improve crying in most babies. […] In some cases, medications may help if your baby has a medical condition known as gastro-oesophageal reflux disease (GORD). […] Most babies who bring up milk are healthy and dont need medical treatment. […] Although it seems logical that reflux might cause babies to cry, studies show that reflux medications do not improve crying in most babies. […] In babies with GORD, your doctor might prescribe medication to help treat these symptoms. […] If your baby has reflux, but not GORD, there are no medications that can help. […] Babies with GORD are sometimes given medications to help reduce stomach acid. […] As with any medication, there are potential risks and side effects for babies.

• #1 Gastrooesophageal reflux disease in infants

  https://www.rch.org.au/clinicalguide/guideline_index/Gastrooesophageal_reflux_disease_in_infants/

  Gastro-oesophageal reflux disease (GORD) should be differentiated from physiological gastro-oesophageal reflux, which is common in healthy, thriving babies and does not require specific investigations or management. […] Empiric use of acid suppression for unsettled infants is not effective and may cause harm. […] The natural history of GORD is of resolution with time; any therapy commenced should be reviewed regularly. […] Simple GOR can cause considerable parental distress, and requires reassurance, support and anticipatory guidance. General measures may minimize symptoms. […] Holding the infant in a head elevated position for 20-30 minutes after feeding may reduce GOR. […] In bottle fed babies, thickened feeds may reduce frequency of vomiting. […] Acid suppressant therapy may be indicated in specific patients with GORD.

• #1 Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1015/p705.html

  Histamine H2 receptor antagonists are an option for acid suppression therapy in infants and children with GERD. […] Proton pump inhibitors are reasonable treatment options for GERD in older children and adolescents, but their use in infants is questionable because of a lack of proven effectiveness. […] Avoid using acid blockers and motility agents such as metoclopramide for physiologic gastroesophageal reflux that is effortless, painless, and not affecting growth. […] Don’t treat gastroesophageal reflux in infants routinely with acid suppression therapy. […] Long-term acid suppression therapy for gastroesophageal reflux disease should be titrated to the lowest effective dose. […] Surgical options are available and should be considered in children with complications from severe GERD if medical therapy is unsuccessful or is not tolerated.

• #1 How To Manage Infant Reflux | SMA HCP

  https://www.smahcp.co.uk/practical-support/feeding-issues/how-to-manage-infant-reflux

  Many parents are likely to have made changes to formulas, feeding positions and winding techniques in an attempt to manage infant reflux. It is helpful to discuss with parents the stepped-care approach to GOR/GORD treatment and set expectations for the timeframe of recovery. Parents should be re-assured that reflux in babies resolves without treatment in 90% of infants by the time they are one year old. […] NICE clinical guidelines state that a breastfeeding assessment is the first-line treatment for breast-fed infants with GOR/GORD. This should be carried out by a HCP with appropriate expertise. […] In formula fed infants with frequent regurgitation associated with marked distress, a stepped care approach is recommended using the following structure: review the infants feeding history; suggest a reduction in feed volumes only if excessive for the infant’s weight; if the infant is consuming large volumes of formula, suggest a trial of smaller, more frequent feeds; offer a trial of thickened formula for reflux.

• #1

  https://www.littleones.co/blogs/our-blog/silent-reflux-in-babies?srsltid=AfmBOopRdnJNvOz0hwwhYASZLvF-w5Dsvc0PrhiDgrTrUK6WvSsoCgqx

  If you think your baby has silent reflux it’s a good idea to write down as many of the signs listed above that your baby may have. […] If prescribed medications dont work, your doctor may consider getting you tested for allergies, or refer you to a gastro specialist to investigate things internally with more invasive studies as mentioned above. […] Definitely contact your GP if your baby is not feeding, is losing weight, is more unsettled than normal or you suspect they have reflux. […] Your doctor may also recommend thickening agents to mix with formula, which can often really help reflux. […] Some mothers find the following more alternative approaches can help relieve silent reflux symptoms: Baby massage therapy (you can learn to do this yourself), Osteopath cranial sacral treatments, Probiotics (make sure you have the correct strains of bacteria), Gripe Water, Colic Calm, or other homeopathic remedies.

• #1 Reflux in babies | Information for the public | Gastro-oesophageal reflux disease in children and young people: diagnosis and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng1/ifp/chapter/reflux-in-babies

  If your baby has any of the following problems, you should go back to see the healthcare professional: If the regurgitation becomes more forceful. […] If your baby brings up milk that is green or yellowish green (it could be bile, a bitter fluid that helps digestion), or if it looks as though it has blood in it. […] If your baby has any new problems or if things get worse such as if he or she will not stop crying or is very distressed, if your baby cannot feed, if he or she stops putting on weight, or if reflux is still a problem in a baby older than 1 year.

• #1 Infant acid reflux – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/infant-acid-reflux/symptoms-causes/syc-20351408

  Infant reflux is when a baby spits up liquid or food. It happens when stomach contents move back up from a baby’s stomach into the esophagus. The esophagus is the muscular tube that connects the mouth to the stomach. […] Rarely, infant reflux leads to weight loss or growth that lags behind that of other children of the same age and sex. These symptoms may mean that your baby has a medical issue. This issue could be an allergy, a blockage in the digestive system or gastroesophageal reflux disease, also called GERD. GERD is a form of GER that causes serious health issues. […] Some of these symptoms may mean serious but treatable conditions. These include GERD or a blockage in the digestive tract. […] If your baby has a more serious condition such as GERD, your baby’s growth may lag behind that of other children. Some research suggests that babies who have frequent episodes of spitting up might be more likely to develop GERD later in childhood.

• #1 Reflux | Children’s Health Queensland

  https://www.childrens.health.qld.gov.au/health-a-to-z/reflux

  Reflux and regurgitation can be very worrying for parents. While it is difficult, it is important to remember that in the majority of cases, reflux will resolve itself without treatment or medication. Ask your family and friends about some other ways to manage your baby’s reflux. […] Some infants and children require medication to help manage reflux. Medication is used to treat gastro-oesophageal reflux disease rather than simple reflux. If your baby or child regurgitates feeds or meals and otherwise behaves as you would expect a normal baby to behave, then they don’t need medication. If your baby or child has pain, long periods of crying and unsettled behaviour, difficulty with feeding and poor weight gain, then your doctor may prescribe medication that helps to reduce acid production such as omeprazole.

• #1 Gastro-oesophageal reflux & GORD 0-2 years | Raising Children Network

  https://raisingchildren.net.au/guides/a-z-health-reference/reflux

  Reflux is very common in young babies because the muscles at the top of their stomachs arent strong enough to stop food or milk from going back up the food pipe. […] Most babies who bring up milk are healthy. Reflux is usually nothing to be concerned about. […] If your child has severe gastro-oesophageal reflux disease (GORD), your GP or the emergency doctor might refer you to a gastroenterologist. […] Most cases of gastro-oesophageal reflux get better by themselves with time and dont 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 youre using thickeners.

• #2 Reflux (GOR) and GORD

  https://www.rch.org.au/kidsinfo/fact_sheets/Reflux_GOR_and_GORD/

  Reflux is when the contents of the stomach are regurgitated (brought back up), either up the oesophagus (food tube) or into the mouth. The medical term for reflux is gastro-oesophageal reflux, or GOR. Most reflux is swallowed back into the stomach, but occasionally your baby will vomit it out of their mouth (which is sometimes called posseting). […] Although it can be very alarming for parents at first, reflux is very common in babies, and will most likely get better on its own by the time your child is one year old. In most cases, reflux will not harm your baby, and does not need any medical treatment. It is unlikely to cause problems later on in life. […] In some instances, reflux can lead to complications. This is called gastro-oesophageal reflux disease (GORD). Your baby will need to see a doctor if they have GORD.

• #2 Treatment for GER & GERD in Infants – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants/treatment

  Most infants with GER do not need treatment. GER symptoms typically improve on their own by the time a child is 12 to 14 months old. Depending on an infants age and symptoms, doctors may recommend lifestyle changes to treat GER or GERD symptoms. […] Doctors may recommend lifestyle changes to help improve symptoms of GER or GERD in infants. […] Doctors may recommend medicines typically proton pump inhibitors (PPIs) or H2 blockers if an infant has esophagitis or has bothersome GERD symptoms that don’t improve after lifestyle changes. […] Doctors don’t often recommend surgery to treat GERD in infants. Doctors may recommend surgery if an infant’s symptoms are severe and other treatments don’t help or if an infant has serious GERD complications.

• #2 Patient education: Acid reflux (gastroesophageal reflux) in babies (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/acid-reflux-gastroesophageal-reflux-in-babies-beyond-the-basics

  Patient education: Acid reflux (gastroesophageal reflux) in babies (Beyond the Basics) […] This article discusses the symptoms, causes, diagnosis, and treatment of babies with GER and GERD. […] TREATMENT […] General measures for all babies — Babies with uncomplicated reflux („happy spitters”) do not require treatment. However, the following measures are appropriate for all babies and may help to improve the reflux symptoms, in addition to other benefits: […] Positioning — It might help to keep your baby upright and calm for 20 to 30 minutes after a feed. […] Trials of dietary changes — If the reflux is still a problem after trying the above measures, you can try thickened feeds or a milk-free diet. […] Medicines — Medications are not recommended for most babies with reflux, because: […] If your baby has concerning symptoms that might be related to acid reflux, such as severe irritability, feeding refusal, or poor weight gain, talk to their health care provider.

• #2 Acid Reflux (GERD) in Babies and Children

  https://www.webmd.com/parenting/baby/infants-children

  What Are the Treatments for Acid Reflux in Infants and Children? […] There are a variety of lifestyle measures you can try for acid reflux in babies and older children: […] For babies: […] Hold the baby upright for 30 minutes after a feeding. […] Thicken bottle feedings with cereal (do not do this without your doctor’s approval). […] Feed your baby smaller amounts of food more often. […] Try solid food (with your doctor’s approval). […] Do not place them in a car seat. […] For older children: […] Elevate the head of the child’s bed. […] Keep the child upright for at least two hours after eating. […] Serve several small meals throughout the day, rather than three large meals. […] Make sure your child is not overeating. […] Limit foods and beverages that seem to worsen your child’s reflux such as high-fat, fried or spicy foods, carbonation, and caffeine.

• #2 20 Tips to Help a Baby With Reflux – New Mom School

  https://newmomschool.com/blog/tips-for-babies-with-reflux/

  If you suspect your baby has reflux, here are 20 tips to try. […] Keep baby elevated 20-30 minutes after feeding (sometimes hard to do!) […] Have baby nap and sleep at an incline with approval by your pediatrician. […] Use a safe swing in the furthest reclined position. […] Use loud white noise. […] Swaddle with a swaddle contraption. […] Attempt to get your baby calm before trying to feed. […] Temperature. Keep temperature cool between 68-72 degrees to help keep baby comfortable. […] Gripe Water is a wonderful natural remedy made with ingredients to help soothe the stomach. […] Gas Drops (Simethicone) Start giving baby gas drops BEFORE feedings starting in the morning to help prevent gas build up throughout the day. […] Colic Calm is a homeopathic remedy to help soothe baby’s tummy.

• #2 Reflux (GOR) and GORD

  https://www.rch.org.au/kidsinfo/fact_sheets/Reflux_GOR_and_GORD/

  For most babies, you don’t have to do anything about reflux and regurgitation. It is a natural process that will resolve by itself with time. Some babies regurgitate more than others this does not necessarily mean there is anything wrong. […] It is possible to reduce the number of reflux episodes holding your baby in a more upright position when feeding. Try keeping them upright for about 20 minutes after their feed. […] If the reflux is causing problems or your baby has GORD, the doctor may suggest some treatment, such as feeding your baby thickened fluids. Pre-made thickened fluids are most suitable but these can cause constipation. […] In some cases, medications can help. These might be a medicine to reduce the acid in the stomach, or medicine to treat an underlying infection. […] Most babies with reflux do not need any treatment at all. […] If the reflux is causing problems, this could be gastro-oesophageal reflux disease (GORD), which may need treatment.

• #2 Childhood Gastro-oesophageal Reflux: Causes and Treatment

  https://patient.info/childrens-health/childhood-gastro-oesophageal-reflux-leaflet

  It can sometimes be beneficial to try increasing the frequency of feeds and also reducing the volume of each feed. […] Thickening feeds can sometimes help. There are different products available which work to thicken your baby’s feeds. Examples of these include Nestargel and Carobel which thicken milk. You should talk with your doctor before using these products. […] Anti-regurgitant formula milks are available – for example, Enfamil AR and SMA Staydown. These can be prescribed by your doctor if your baby has more severe gastro-oesophageal reflux. […] Gaviscon (sodium alginate) works by making the contents of the stomach thicker so they are then more likely to stay in the stomach. […] Acid-reducing medications are sometimes used for infants and children with GORD, particularly if other measures haven’t worked.

• #2

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/GERD-Reflux.aspx

  GER or GERD is treated in babies and children through lifestyle changes including feeding and/or position changes as first-line therapy. […] If GERD is severe, treatment may include medication or surgery. Medications can reduce or neutralize stomach acid to treat symptoms. The surgery to correct reflux is called fundoplication. […] Treatment options for infants include burping your baby at natural pauses in feeding in an upright position, keeping your baby in an upright position for the first half-hour after feeding, and considering smaller and more frequent feedings. […] If your bottle-fed baby spits up unusually often, your pediatrician may recommend thickening their formula with a very small amount of baby cereal. […] Since milk allergy can cause symptoms similar to GER or GERD, your pediatrician might suggest trying a dairy-free diet if you’re breastfeeding. […] Regardless of whether your baby’s symptoms warrant watchful waiting or medical treatment, the AAP does have simple feeding suggestions that can help.

• #2 Infant acid reflux – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/infant-acid-reflux/symptoms-causes/syc-20351408

  Infant reflux is when a baby spits up liquid or food. It happens when stomach contents move back up from a baby’s stomach into the esophagus. The esophagus is the muscular tube that connects the mouth to the stomach. […] Rarely, infant reflux leads to weight loss or growth that lags behind that of other children of the same age and sex. These symptoms may mean that your baby has a medical issue. This issue could be an allergy, a blockage in the digestive system or gastroesophageal reflux disease, also called GERD. GERD is a form of GER that causes serious health issues. […] Some of these symptoms may mean serious but treatable conditions. These include GERD or a blockage in the digestive tract. […] If your baby has a more serious condition such as GERD, your baby’s growth may lag behind that of other children. Some research suggests that babies who have frequent episodes of spitting up might be more likely to develop GERD later in childhood.

• #2 Reflux in Babies: Signs & Treatment

  https://my.clevelandclinic.org/health/diseases/reflux-in-babies

  Reflux in babies is common among babies in their first year and usually harmless. But it’s sometimes a sign of gastroesophageal reflux disease (GERD) or other conditions that need medical treatment. […] GERD refers to chronic acid reflux that may affect a person’s quality of life and damage their esophagus. Babies with GERD need closer monitoring and may benefit from treatment like medications. […] Treatment for your baby’s reflux depends on its severity. Babies with GER don’t need medications. Instead, they may benefit from changes to their feeding routine. Such changes can also help babies with GERD, but these babies sometimes need medications. Rarely, babies with GERD need surgery. […] Healthcare providers only prescribe medications for babies who clearly have GERD, and even then, only in select cases. Medications like proton pump inhibitors (PPIs) can help manage complications of GERD, like inflammation in your baby’s esophagus (esophagitis). But they come with risks and side effects, so providers use them only when necessary and for as short a time as possible. […] If other measures aren’t enough to treat GERD or its complications, surgery may be an option. A pediatric gastroenterologist can tell you more about surgical options, including laparoscopic Nissen fundoplication. Providers consider surgery in infants only in select cases.

• #2 Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1015/p705.html

  Histamine H2 receptor antagonists are an option for acid suppression therapy in infants and children with GERD. […] Proton pump inhibitors are reasonable treatment options for GERD in older children and adolescents, but their use in infants is questionable because of a lack of proven effectiveness. […] Avoid using acid blockers and motility agents such as metoclopramide for physiologic gastroesophageal reflux that is effortless, painless, and not affecting growth. […] Don’t treat gastroesophageal reflux in infants routinely with acid suppression therapy. […] Long-term acid suppression therapy for gastroesophageal reflux disease should be titrated to the lowest effective dose. […] Surgical options are available and should be considered in children with complications from severe GERD if medical therapy is unsuccessful or is not tolerated.

• #2

  https://bpac.org.nz/bpj/2011/november/infant-reflux.aspx

  Referral to a paediatrician (or paediatric gastroenterologist where available) for diagnostic investigations is indicated when an infant has excessive reflux and: A failure of conservative treatment (such as feeding advice). […] Histamine receptor antagonists such as ranitidine reduce histamine induced gastric acid and pepsin release. Ranitidine has been shown to be effective in the treatment of some cases of oesophagitis in children, and is associated with a low incidence of adverse effects. However, as with omeprazole, there is no evidence to support empiric treatment of infants with symptoms of irritability and reflux. […] Alginates such as a mixture of sodium alginate and magnesium alginate (Gaviscon infant) reduce acidity and reflux through increasing the viscosity of gastric contents. They can be used to relieve symptoms of regurgitation or reflux in infants.

• #2 Pediatric Gastroesophageal Reflux Treatment & Management: Approach Considerations, Positioning, Dietary Measures

  https://emedicine.medscape.com/article/930029-treatment

  Surgical treatment of gastroesophageal reflux should be considered for infants and children who have failed step-up therapy for gastroesophageal reflux (typically over 12 wk) and those who cannot be weaned off of acid-reducing medications. […] Patients with complications of gastroesophageal reflux, such as aspiration, stricture of the esophagus, or Barrett esophagus, should be considered for surgical treatment.

• #2 Acid Reflux (GERD) in Babies and Children

  https://www.webmd.com/parenting/baby/infants-children

  Encourage your child to get regular exercise. […] If the reflux is severe or doesn’t get better, your doctor may recommend medication. […] Drugs to Neutralize or Decrease Stomach Acid […] Drugs to decrease stomach acid include: […] Antacids such as Mylanta and Maalox […] Histamine-2 (H2) blockers such as cimetidine (Tagamet) or famotidine (Pepcid) […] Proton-pump inhibitors such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), omeprazole-Sodium Bicarbonate (Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex) […] For the most part, drugs that decrease intestinal gas or neutralize stomach acid (antacids) are very safe. […] Surgery for GERD in Babies and Kids […] Surgery isn’t often needed to treat acid reflux in babies and kids. […] When it is necessary, a fundoplication is the most often performed surgery. […] During this procedure, the top part of the stomach is wrapped around the esophagus forming a cuff that contracts and closes off the esophagus whenever the stomach contracts — preventing reflux. […] The procedure is usually effective, but it is not without risk.

• #2 Gastro-oesophageal reflux | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/gastro-oesophageal-reflux/

  Initially, the childs feeds and feeding pattern may be adjusted to see if that improves the symptoms. For instance, feeding smaller amounts more frequently will be suggested along with changes to their feeding position, such as sitting them in a more upright position during feeds and immediately afterwards. […] Medications may also be suggested some form a barrier on top of the stomach contents to reduce the risk of them flowing backwards, while others damp down acid production in the stomach. Another type of medication speeds up the rate at which feed passes from the stomach into the duodenum and intestines. All these medications take some time to work but can be very helpful for the majority of children. […] If a child has severe gastro-oesophageal reflux which is not controlled with medication or is causing significant complications, your doctor may recommend an operation called a fundoplication to prevent reflux. Before reaching this decision, the severity of the childs reflux will usually be assessed with an upper GI contrast study and a pH or impedance study. As every child is different, the decision to recommend surgery will only be made after these assessments have been completed. The fundoplication operation uses the top of the stomach to strengthen the sphincter so it is less likely to allow food, drink or acid to travel back into the foodpipe. […] The options for treating gastro-oesophageal reflux disease are improving all the time, with new medicines and surgical options being discovered alongside a better understanding of why a child develops gastro-oesophageal reflux disease.

• #2 Medical management of gastro-esophageal reflux in healthy infants | Canadian Paediatric Society

  https://cps.ca/en/documents/position/gastro-esophageal-reflux-in-healthy-infants

  Non-pharmacological therapies to be considered for healthy infants with suspected GERD include thickened feeds, avoiding cows milk protein, and infant positioning. […] Recent international guidelines state that a 2-week trial of thickened feeds may be attempted for infants with GERD who display significant vomiting. […] A 2- to 4-week trial of cows milk protein avoidance can be tried when other non-pharmacological measures to treat symptoms attributed to GERD have failed. […] Pharmacological agents to treat GERD in infants include acid-suppressive medications (H2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs)) and prokinetics. […] In keeping with recent international recommendations and a CPS recommendation made for the Choosing Wisely Canada campaign in 2017, acid-suppressive therapy should not be routinely used for the treatment of crying, fussing, arching, or regurgitation in otherwise well infants. […] Because the natural history of GERD symptoms is to resolve over time, trials of therapy with acid-suppressive agents to establish a diagnosis of GERD are not recommended. […] Scant evidence to support the efficacy of prokinetics and accumulating evidence for their significant negative side-effects both indicate they should not be used routinely to treat otherwise healthy infants with symptoms of GERD.

• #2

  https://bpac.org.nz/bpj/2011/november/infant-reflux.aspx

  In New Zealand, empiric treatment with omeprazole for infant irritability and reflux is increasing, despite the fact that it is not approved for this condition, is unlikely to improve symptoms and the potential adverse effects are largely unknown. Omeprazole should only be considered for infants in cases of gastro-oesophageal reflux disease (GORD) associated with severe reflux oesophagitis or failure to thrive. […] Omeprazole is not a recommended treatment for reflux or uncomplicated GORD in infants. […] Omeprazole is therefore not recommended for treating irritability, reflux or uncomplicated GORD. Omeprazole should only be considered in cases of severe infantile reflux oesophagitis or if GORD is causing complications such as failure to thrive. […] A primary care based study found that two weeks of conservative treatment (feeding modifications, positioning and avoidance of tobacco smoke) improved symptoms in 78% of infants with frequent regurgitation and irritability and symptoms completely resolved in 24% of infants during the study period.

• #2 GERD in Children | Treatment for Acid Reflux in Kids | GI Care for Kids

  https://www.gicareforkids.com/conditions-we-treat/gastroesophageal-reflux-disease-gerd/

  Avoid GERD medications such as H2-blockers or proton pump inhibitors for crying, distress, or visible regurgitation in otherwise healthy and strong infants. […] For the older child: Conduct a four- to eight-week trial using proton pump inhibitor medication. […] Common medications used to treat GERD in children include: Antacids and alginates – Medications designed to neutralize acid and relieve symptoms such as heartburn or dyspepsia. […] Surgical approaches to decrease acid reflux are usually undertaken only after all other options have failed. […] Fundoplication may be appropriate for infants and children with GERD if: Life-threatening complications like cardiorespiratory failure exist after more conventional treatment methods have failed.

• #2 Pediatric Gastroesophageal Reflux Treatment & Management: Approach Considerations, Positioning, Dietary Measures

  https://emedicine.medscape.com/article/930029-treatment

  Surgery is required in only a very small minority of patients with gastroesophageal reflux. […] For patients who fail medical therapy, continuous intragastric administration of feeds alone (via nasogastric tube) may be used as an alternative to surgery. […] Thickening an infant’s formula provides a therapeutic advantage against gastroesophageal reflux, particularly when excessive vomiting is associated with suboptimal weight gain. […] Guidelines from the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) discuss the use of step-up and step-down therapies, which should be instituted under the guidance of a pediatric gastroenterologist. […] The goals of medical therapy in gastroesophageal reflux are to decrease acid secretion and, in many cases, to reduce gastric emptying time.

• #2 Understanding Infant Reflux: A Guide for Parents and How Osteopathic Manual Therapy Can Help — Healthy Mumma & Baby

  https://www.healthymumma.com/blog/understanding-infant-reflux-a-guide-for-parents-on-osteopathic-treatment

  Reflux can be more complicated for babies that are oozing or spitting up multiple times a day. […] The birthing process itself can contribute to reflux issues. […] A pediatric osteopath can assess and properly address these issues with manual therapy, cranio-sacral therapy, and home exercises. […] Seeing a lactation consultant can be helpful to help with any feeding issues. […] Osteopathy is a holistic, manual approach to treating body tensions, strains and dysfunctions. […] For infants with reflux, osteopathic manual therapy can offer targeted and gentle interventions to address underlying issues contributing to the discomfort. […] Osteopathic techniques can help improve the function of the diaphragm and gut tube. […] If there are no medical concerns, consider osteopathy to help relieve pain and discomfort, tensions and restrictions, associated with the reflux.

• #2

  https://coliccalm.com/pages/acid-reflux-cause-and-treatment-babies?srsltid=AfmBOoqu0qnFtx1SecssmZt98Oxm_HClXpj1d1Fh6tWBj5t-mBKaBaoZ

  If these measures dont work, the next step is to speak to your doctor about diagnostic evaluation and treatment options. Prescription medicines reduce stomach acid, thereby suppressing the symptoms of esophageal inflammation and pain associated with reflux. […] Surgery is a last resort, and it is reserved for severe cases with dangerous complications, and only after all other treatment has failed. […] A natural option is gripe water for reflux such as Colic Calm that does not expose baby to such side effects is usually preferable to drugs or surgery.

• #2 Understanding Infant Reflux: A Guide for Parents and How Osteopathic Manual Therapy Can Help — Healthy Mumma & Baby

  https://www.healthymumma.com/blog/understanding-infant-reflux-a-guide-for-parents-on-osteopathic-treatment

  Infant reflux is a common condition in which stomach contents flow back into the esophagus. […] While many infants experience some degree of regurgitation, persistent or severe cases will typically require professional intervention. […] This guide is not meant to diagnose your baby’s problem. It is important that your baby is feeding and digesting well, so please do not hesitate to contact your doctor or midwife if you suspect your baby has reflux. […] Seek immediate medical help if your baby has persistent or worsening symptoms, isn’t gaining weight, spits up forcefully (vomits), spits up green or yellow fluid, spits up blood or a material that looks like coffee grounds, refuses feedings repeatedly, has blood in his or her stool, has difficulty breathing or other signs of illness, begins spitting up at age 6 months or older, cries for more than three hours a day and is more irritable than normal, or has fewer wet diapers than usual.

• #2 What are the Signs of Reflux in Babies? | Philips Avent

  https://www.usa.philips.com/c-e/mo/parents-guide/for-professionals/reflux-in-babies.html

  If a baby experiences forceful vomiting, blood in his or her stool, or any of the above symptoms of GERD, parents should contact a healthcare professional. […] The signs of reflux in babies will usually go away on their own, however, the following tips may help relieve symptoms in the meantime: Thicken feeds with rice cereal or special milk thickener. […] These tips are designed to relieve and symptoms, but shouldnt replace the advice of a doctor. […] Although GERD is a slightly more serious condition, there are plenty of treatments and methods to manage it and help newborns.

• #2 Gastroesophageal Reflux in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=gastroesophageal-reflux-in-children-90-P02364

  Reflux can happen at any age, but its common in babies. […] Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is. […] Most babies with reflux have no symptoms other than spitting up often. As long as these children grow well and dont have other issues caused by reflux, they dont need treatment. […] Sometimes reflux can be managed with feeding changes. These changes should be made under the care of your babys healthcare provider. […] Your baby may need reflux medicine. These medicines can decrease the amount of acid the stomach makes. This will ease the heartburn caused by reflux. […] In severe cases, your child may need surgery. This surgery is done to reinforce the lower esophageal sphincter. This helps keep the reflux from happening. […] Many babies with reflux will outgrow it by the time they are age 1. This is when the lower esophageal sphincter becomes stronger. For other babies, feeding and lifestyle changes and medicine can help. Work with your childs healthcare team to create a care plan for your child.

• #2 Understanding Reflux in Babies | Children’s Health

  https://www.childrens.com/health-wellness/understanding-reflux-in-babies

  Another option your baby’s pediatrician may suggest is eliminating cow’s milk protein from your baby’s diet. […] If lifestyle modifications aren’t enough to control your baby’s reflux symptoms, the next treatment course is typically trying to thicken their feeds. […] If your baby doesn’t improve using lifestyle modifications or with thickened feeds, your pediatrician will likely refer your baby to a pediatric GI doctor. […] „Although reflux can be distressing for babies and parents, it’s important to realize that the condition will pass, and most babies with reflux will not have any long-lasting effects,” says Dr. Llanos Chea.

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