Gastroesophageal Reflux Disease, GORD

Gastroesophageal Reflux, GOR

More than 30% of children suffer with problems of gastroesophageal reflux causing regurgitation.
Symptoms require medical assessment and advice.
Symptoms are generally not dangerous in a baby of less than 2 months old, and it does not affect their development. However, symptoms sometimes can be severe enough that it can affect the baby's growth.
Reflux usually disappears after a few months, often when the child is being weaned or when he is more upright for example sitting and walking.

Symptoms of reflux must be regarded as abnormal if it occurs
  • Outside of meal times.
  • During the night
  • Frequent and or persistant
  • Occurs when changing the baby's position
  • Cries after meals or during the night
  • Presence of blood in posset/vomit

Benign symptoms of reflux

  • Posset after meals
  • Small amounts
  • Onset of symptoms before 3 months
  • Normal growth of the baby
  • Normal appetite

More severe symptoms of reflux

  • Persistent vomiting which can be projectile
  • Sore throats (Tonsillitis), frequent ear infections and dental erosion
  • Bronchitis, persistent coughs, wheezing and hoarseness
  • Reduced responsiveness and alertness
  • Oesophagitis (inflammation of the food pipe)
  • Growth delay

Coping with reflux

  • Position your child upright when feeding/eating, but not too upright that you compress its abdomen
  • Avoid tight nappies.
  • Ensure formula feeds are mixed thoroughly and contain no lumps in the feeding bottle.
  • Elevation of the head of the bed - advisable for children over 1 year .
  • Avoid handling and moving your baby too much after meals and promote a restful atmosphere.
  • Do not smoke anywhere near your baby and avoid smoky areas.
  • Avoid giving cereals and fruit juices
  • Thickened milk or thickening agents can be used: See your GP or dietician for these.
  • Anti colic teats can be purchased which decrease the teat flow.
  • Space out the meals or feeds
  • Keep the baby in your arms after feeding him
  • Avoid large amounts of feed
  • Be patient - allow time for him to feed

To listen to your doctor's or health visitors advice on the best choice of milk.

Sometimes, medication is prescribed in order to protect the walls of the oesophagus (food pipe) and to neutralise acidity there are protective agents that coat the oesophagus and act as a barrier to the entrance of the stomach stopping acid reflux. Other agents help with digestive emptying and motility and others inhibit acid secretion.

Treatments in general are prescribed until the toddler stage, allowing the baby to hold himself more upright, which improves the symptoms of reflux.

Sometimes further investigation is necessary to help diagnose the cause for reflux; such as endoscopy, PH studies and X-ray studies and in some cases surgery is required to correct any problem detected.

Differences between vomiting and regurgitation

Regurgitation is carried out without effort whereas vomiting requires the contraction of the abdominal muscles. But sometimes vomiting and reflux are associated.
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