Infants with acid reflux

Q.What are symptoms of acid reflux in infants? My son spits up what I think is quite a bit, but my first never spit up so I don't have much of a comparison. Is excessive spit up even a symptom?

A.These are some of the more common symptoms of reflux. Your baby may only have some of them, and may have other symptoms that are not listed. (I * the ones my son had) Spitting up frequently Vomiting Unexplained crying-colicky behavior* Poor sleep; frequent waking * Fighting/crying during feeding * Arching neck or back during feeding * Frequent hiccups * Congestion * Wheezing * Coughing * Hoarseness Strange odor on breath * Poor weight gain Frequent choking episodes Fusses when legs are lifted during diaper change: the bend in the tummy put pressure on the stomach and causes reflux to be worse* Fusses when in sitting position, like in a car seat: the bend in the tummy put pressure on the stomach and causes reflux to be worse.* Chewing or smacking of lips after feedings* Apnea-spells of not breathing Bradycardia-spells of slow heartrate Wet Burps* Curdled spit up* Important: There are a couple of common misconceptions about reflux: First, your baby does not have to be losing weight to have reflux. On the contrary, many reflux babies actually overeat because eating eases the pain. Second, your baby does not have to be spitting up to have reflux. This is known as "silent reflux" and can actually be harder on your baby because their esophagus is getting burned by the acid on the way up and again when it goes back down. It's also a lot harder to recognize as reflux. If your baby is exhibiting signs of reflux, you should talk to your pediatrician about it. Be forewarned though that many pediatricians only consider reflux to be a problem if the baby isn't gaining weight properly. Beyond that, many seem to think it's merely a laundry problem for an overreacting parent and will tell you that your baby will grow out of it and send you on your way. Yes, your baby will grow out of it, but if your baby is experiencing pain and discomfort from reflux, there's no reason why he should have to suffer while he's growing out of it! You need to make sure that your doctor understands that your baby is in pain and that you're not complaining about the laundry. And if he still doesn't listen, find another doctor. Things YOU can do to help you child with reflux Keep infants upright during feedings, and for at least 30 minutes after feedings. This will decrease the amount of gastric reflux. Placing them in a swing, bouncer, car seat (as stated below) will put a bend in their tummy area which will put pressure and could cause reflux to worsen. Hold or wear your baby in an upright postion. If you lay the infant down after feeding, place the baby on his/her stomach (prone position) on an incline of at least 30 degrees. This can reduce regurgitation. But only place the infant in this position if he/she is awake. Laying on the stomach is not recommended during sleep for infants from birth to 12 months because of the link between this position and sudden infant death syndrome. Based on guidelines set forth by the American Academy of Pediatrics, positioning the infant on his/her back (supine position) during sleep is generally recommended. In infants with GERD, the risk of SIDS generally outweighs the potential benefits of prone sleeping. Prone positioning during sleep is only considered in unusual cases where the risk of death from complications of GER outweighs the potential increased risk of SIDS. It is very important to discuss this with the infant's doctor before undertaking any changes in sleeping positions. As noted above, position the infant on his/her back, and elevate the head of the bed 30 degrees. Gravity will help keep stomach contents where they belong. Smaller, more frequent feedings Feedings every two to three hours when the infant is awake will reduce the occurrence of gastric reflux. Overfeeding can increase abdominal pressure, which can lead to gastric reflux. Diet modifications for mothers who breast-feed Certain foods, such as dairy, caffeine, chocolate, and garlic can promote reflux, so if you breast-feed your infant, you should consider cutting these foods out of your diet. I've had to cut out TONS of foods! Milk, chocolate, caffine, tea and coffee (even decaf!), any carbonated beverage, eggs, tomatos, spicy foods, beans, broccoli, cauliflower, cabbage, onion, garlic, citrus fruits, apples, I could go on!! LOL I just pretty much eat pasta, rice, potatoes, yams, chicken and pears! Burping the infant several times during the feeding will help minimize gastric pressure, and the reflux it can cause. Waiting to burp the infant after he/she has a full stomach can increase the chances of regurgitation. Avoid tight elastic around the waist, and keep diapers loose. Don't give your infant caffeinated beverages, orange juice or other citrus juices. The way the infant is positioned in the car seat can cause regurgitation to increase. If the infant slouches over, it causes abdominal compression, increasing the risk of reflux. Using simple supports to keep the infant upright will prevent this. Let gravity help your baby whenever possible. Keeping your baby upright during feeding and for 30-45 minutes afterwards will help a lot. Also, many reflux babies have a really hard time laying flat to sleep. Finding a sleeping position that will be comfortable for your baby can be quite a challenge. Let him sleep in a bouncy seat Elevate the head end of the crib by placing books under the legs Elevate the head end of the crib mattress by placing a pillow or quilt underneath Use a crib wedge Use a Tucker Sling It's always preferable if you can relieve your baby's symptoms just by making changes in his feeding and positioning, but if you've tried all that and your baby is still suffering, there are medications that you might want to ask your pediatrician about. I tried for 6 weeks to do anything and everything do avoid medication, but my son's reflux is just to severe. He's been on meds for 2 weeks and he is A LOT better. And remember, the acid in the stomach can cause burns and ulcers for your child.

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