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Talking to the Doctor About Infant Reflux

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Updated February 26, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

A certain amount of reflux is normal in infants, especially during the first three months of life. However, infant reflux can become a concern for some babies. This is when medical attention is needed, and when a doctor will decide if treatment for the infant's reflux is needed.

When Should You Call the Doctor

How do you know when you should talk to your baby's doctor about his or hers reflux? You should keep the following points in mind:
  • If your baby doesn't seem to be in any distress and is still gaining weight fine, you probably don't have anything to worry about. You certainly should mention the reflux at your baby's next checkup.

  • If your baby seems distressed when eating or afterwards, isn't gaining weight or is losing weight, you should take your baby to the doctor as soon as possible.

Other signs or symptoms to watch for are:

Frequent spitting up or vomiting For many infants, they will spit up at some point during the first three months of their life. They usually won't need any treatment for this, and they will usually outgrow this. What is a concern is spitting up, or reflux, that is severe, that lasts beyond the time it should have eased. For other infants, their spitting up, or reflux, is severe. This could require one or more treatments.

Irritability when feeding This irritability includes whining, crying, screaming, and fussiness, which can last for varied amounts of time. This irritability can stem from the burning sensation and pain in the esophagus when formula and stomach acid is refluxed into the esophagus.

Refusing food or eating only small amounts Infants may refuse to eat if pain occurs when they swallow. This pain can be caused by the irritation in the esophagus when formula and stomach contents are refluxed back up into the esophagus.

Arching the back while feeding When babies are experiencing abdominal pain or discomfort, they will often arch their backs or draw up their legs. Frequent coughing
A frequent cough may occur if refluxed stomach acid is aspirated, irritating the airways, or when the stomach acid irritates the throat.

Poor sleep habits with frequent waking When an infant is sleeping and his or her head isn't elevated, this allows stomach contents to press against the lower esophageal sphincter (LES), and can cause it to open inappropriately. When stomach contents are refluxed into the esophagus, it can cause coughing and a choking sensation, which in turn can make sleeping more difficult.

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A small number of infants will experience the following less common symptoms:

Respiratory problems (such as asthma, pneumonia, bronchitis, wheezing) Several studies suggest a significant link between GERD and asthma. GERD can affect asthma when refluxed acid from the stomach is aspirated into the lungs, and can make breathing difficult and cause the infant to wheeze and cough. This refluxed acid can cause other types of irritation in the lungs, leading to increased odds of pneumonia and bronchitis.

Excessive drooling Excessive drooling usually occurs from improper, inefficient, or infrequent swallowing. If irritation is present in an infant's throat because of refluxed stomach acid, the infant may find it difficult to swallow frequently maybe, and thus will drool more.

Hoarse voice (hoarse cry) Irritation caused by refluxed stomach acid into the throat can lead to hoarseness.

Preparing for the Doctor's Visit

Write down your questions. Before your visit, write down any questions you can think of. This will not only help you remember what you need to ask, it will also enable you to ask your questions at the beginning of your baby's appointment. While doctors are willing to answer questions toward the end of a visit, there may not be adequate time to discuss all your concerns or answer all your questions if you wait until the end of the appointment to mention them.

Keep a record of your baby's symptoms. Write down when your baby's reflux occurs. Remember to include any symptoms of reflux you see, and any mood changes you see (irritability when feeding or soon afterwards, etc). This will help the doctor see how often the reflux occurs, how severe it is, and how it affects your baby.

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Sources:

"Gastroesophageal Reflux in Infants." NIH Publication No. 06–5419 August 2006. National Digestive Diseases Information Clearinghouse (NDDIC).

Marsha Kay, M.D., Vasundhara Tolia, M.D.. "COMMON GASTROINTESTINAL PROBLEMS IN PEDIATRIC PATIENTS." The American College of Gastroenterology.

Brian Pace, MA, Richard M. Glass, MD. "Gastroesophageal Reflux in Children." JAMA, July 19, 2000---Vol 284, No. 3. The Journal of the American Medical Association.

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