GERD and Acid Reflux in Infants and Children
Most infants occasionally spit up throughout the day. However, when regurgitation causes other problems or is associated with other symptoms, it may be due to gastroesophageal reflux disease (GERD), which can also occur in older children.
What Are the Symptoms of Acid Reflux in Infants and Children?
The most common symptoms of reflux in kids are:
- Frequent or recurrent vomiting
- Frequent or persistent cough
- Refusing to eat or difficulty eating (choking or gagging with feeding)
- Crying with feeding
- Heartburn, gas, or abdominal pain
Many other symptoms are sometimes blamed on gastroesophageal reflux, but much of the time, it isn't clear if reflux actually causes them. Other possibilities in young children and infants include:
- Poor growth
- Breathing problems
- Recurrent pneumonia
What Causes GERD and Acid Reflux in Infants and Children?
Like in adults with the condition, gastroesophageal reflux is the upward movement of stomach contents into the esophagus and sometimes into or out of the mouth.
Usually, infants with the condition are otherwise healthy, but some babies have other problems affecting their nerves, brain, or muscles. According to the National Digestive Disease Information Clearinghouse, a child's immature digestive system is usually to blame. They add that most infants grow out of GERD by the time they are 1 year old.
In older children, the causes of GERD are also different than what is seen in infants and adults. Anything that causes the muscular valve between the stomach and esophagus (the lower esophageal sphincter or LES) to relax, or anything that increases the pressure below the LES, can cause GERD. Such things include obesity, overeating, constipation, and certain foods, beverages, and medications.
How Is Acid Reflux Diagnosed in Infants and Children?
Usually, the medical history as told by the parent is enough for the doctor to make a diagnosis of acid reflux, especially if the problem occurs regularly and causes discomfort. Occasionally, further tests are recommended. They may include:
- Barium swallow or upper GI series. This is a special X-ray test that uses barium to highlight the esophagus, stomach, and upper part of the small intestine. This test may identify any obstructions or narrowing in these areas.
- pH probe. During the test, the patient is asked to swallow a long, thin tube with a probe at the tip that will stay in the esophagus for 24 hours. The tip is positioned, usually at the lower part of the esophagus, and measures levels of stomach acids. It also helps determine if breathing problems are the result of reflux.
- Upper GI endoscopy. This is done using an endoscope (a thin, flexible, lighted tube and camera) that allows the doctor to look directly inside the esophagus, stomach, and upper part of the small intestine.
- Gastric emptying study. During this test, the child drinks milk or eats food mixed with a radioactive chemical. This chemical is followed through the gastrointestinal tract using a special camera. Some patients with GERD have a slow emptying of the stomach that may be contributing to the reflux of acid.