Why does reflux occur in babies and children? The esophagus is a tube that carries food from the mouth to the stomach. When there is reflux, food from the stomach returns to the esophagus involuntarily. These events are normal in healthy infants. There is a muscle (the lower esophageal sphincter) that acts as a valve between the esophagus and the stomach. When the child swallows, this muscle relaxes to allow food to pass from the esophagus to the stomach. The rest of the time this muscle remains closed. In children with gastroesophageal reflux, the lower esophageal sphincter presents involuntary transient relaxations allowing gastric contents to be returned to the esophagus. Most of these episodes are brief, and children remain healthy and buoyant, even if they spit up or vomit. If the baby regurgitates without discomfort and has adequate weight gain, it is considered normal for age, says the doctor, a pediatric gastroenterologist from the pediatric group at the Medical Center.
If the reflux is persistent and prolonged, the child could present malnutrition, upper respiratory symptoms, asthma, bronchopneumonia, loss of appetite, irritability, anemia, digestive bleeding. Knowing these alarm symptoms in time and treating them is definitive to avoid complications.
Physiologic (normal) regurgitation improves with general measurements and growth of the child. At three months of age, 50% of infants may have reflux, at four months 67%, it decreases with age and at twelve months it can persist in only 5%.
ALARM SIGNS
Infants with pathologic reflux may also have respiratory complications such as pneumonia, sinusitis, earaches, dry nocturnal cough, wheezing and asthma attacks at night, irritability, anemia, malnutrition, difficulty swallowing, bloody vomit, and impaired sleep pattern, clarifies the specialist.
In older children and adolescents, symptoms of concern should be considered: repeated vomiting, frequent sensation of food or liquid reaching the throat or mouth, persistent pain in the chest or abdomen, pain and difficulty swallowing (feeling that food gets stuck in the esophagus), chronic cough, hoarseness, and asthma.
RECOMMENDATIONS
- If we have an infant with reflux without symptoms and with adequate weight gain, we must avoid overfeeding, do not give food after regurgitation, and wait for the next feeding hour.
- If he is fed with breast milk, he should continue, depending on the case, it would be considered to thicken the formula. It may help if the baby is in an upright position (sitting or upright) during feedings. Most infants improve with these basic measures.
- It is advisable to consult the doctor to determine if the baby is feeding properly. If the symptoms are severe and persist despite having made the general recommendations, an assessment by the pediatric gastroenterologist is necessary, who will consider what medical treatment and tests the patient needs.
- Older children and teens often feel better if they avoid foods and drinks that seem to trigger reflux symptoms, including: citrus fruits, chocolate, caffeinated beverages, and high-fat foods. Obesity, alcohol consumption and smoking should be avoided. Raising the head of the bed 6 to 8 inches (15 to 20 cm) is recommended to minimize reflux that occurs at night.
If your child, at any age, presents the alarm signs, do not forget to consult the specialist in a timely manner to prevent severe malnutrition, asthma, bronchopneumonia and recurrent respiratory symptoms, anemia and digestive bleeding.