Well, to begin with, what exactly is this GERD or Gastroesophageal reflux disease?
Gastroesophageal reflux per se is a normal phenomenon in which sometimes the contents of the stomach regurgitate back into the esophagus or foodpipe. It occurs in practically everyone; right from the newborn period to infancy and even in children and adults.
But, if the reflux occurs too often or affects the health of the person, then it is abnormal. That is when it is called Gastroesophageal reflux Disease.
Now, what causes GERD?
1. Inherent weakness of the muscles of the foodpipe.
2. Prematurity: premature babies are more prone to GERD.
3. Certain foods like chocolates, coffee, mint, tomatoes, juices, carbonated drinks.
4. Poor eating habits like excessive gaps between meals, immediately lying down after eating, eating too spicy foods.
5. It could also be genetic.
Now, let’s talk about GERD in different age groups:
Newborns and infants:
The reflux as such is very common in newborns and infants. It is at its peak by about 4 months of life and disappears in 88% of babies by 1 year of age and in nearly all by 2 years. That is the usual possetting or little removal of curd or milk after feeds. This process is effortless and in fact occurs in almost all babies. But, it is abnormal if:
1. The infant vomits a lot
2. Not gaining weight
3. Continuosly crying, irritable, always hungry
4. Is Choking, coughing and arches his/her back on and off.
5. Refuses to feed or feeding aversion
6. Persistent hiccups
There are 2’P’s of managing such babies:
1. Position: Keep the infant upright after feeds. Do not keep them in semi seated or seated position. That aggravates the reflux immediately after feeds. During sleep time, supine position (lying on the back) is good enough. They can be kept in prone position (lying on tummy) only when they are awake and under supervision.
2. Paediatrician: Get in touch with your paediatrician when you notice the above symptoms. Your doctor will guide you in how to manage the feeds; how much to give and how frequent, thickening of the feeds, and medicines that are to be given. He/she may also make you undergo some tests for the baby if required.
Toddlers and older children may also experience symptoms of GERD. A few of them are as follows:
1. They may have food refusal
2. Complain of chest pain or abdominal pain
3. Persistent cough and wheezing
4. Sleep disturbances
5. Dental erosion
Again, 2 ‘P’s of managing such children.
1. Position: They can be encouraged to move about immediately after food. If there are sleep disturbances, you can make them sleep in left lateral position with head end of the bed elevated. Also, foods that cause reflux, as mentioned above, should be avoided.
2. Paediatrician: He/she will guide you in the consumption of the necessary medicines and doing any tests if required.
GERD in children and adults are due to entirely different causes. In adults, it’s mainly because of lifestyle and eating habits.
GERD if neglected or untreated has disastrous consequences. Apart from the anxiety that it causes in the parents, it has numerous effects on the infant and child’s well being too.
So, what are these consequences?
1. Untreated GERD can cause recurrent pneumonia in the child.
2. Continuous cough and wheezing leads to asthma in later life.
3. Also, it aggravates ear infections and sinusitis.
4. If still untreated, the continuous reflux can damage the foodpipe severe enough to cause its blockage.
5. The lack of weight gain leads to multiple nutrient deficiencies.
So, it is important to recognize the symptoms and signs early and treat them. Infants and young children are unable to vocalise their symptoms. Hence, we as parents, need to be aware of this condition and seek treatment when necessary. So, we all need to be aware of GERD.
P.S.: Source of the above information – Nelson Pediatrics: 20th edition and personal experience.
Pic courtesy: Google images
Author’s note: This post first appeared on mycity4kids parenting platform.