A small amount of acid reflux occurs in all children. It is part of normal physiology that stomach acid goes up into the oesophagus, often during or after a meal, but this shouldn’t cause any significant distress. A distinction should be made between gastro-oesophageal reflux (GOR) and gastro-oesophageal reflux disease (GORD). GORD occurs in far fewer children, and is only present when GOR leads to significant medical symptoms and/or complications.
Acid reflux in children
Acid reflux occurs in all normal children. It is due to stomach acid going up into the oesophagus, most often during or after a meal, and may cause discomfort and pain to the child.
A distinction should be made between GOR and gastro-oesophageal reflux disease (GORD), which occurs in far fewer children when GOR leads to significant medical symptoms and complications.
GORD symptoms in younger children include regurgitation, vomiting, pain during or immediately after feeding, fussy eating and refusing feeds. In older children, symptoms can include pain on swallowing, excessive burping, heartburn, a frequent cough, persistent nausea and pain when lying down.
What causes acid reflux in children?
Although regurgitation and vomiting can be symptoms of a number of underlying conditions, GORD itself is caused by a number of different, mostly mechanical and developmental factors. Fortunately, these most often improve by themselves with age, as the maturity of the lower oesophageal sphincter improves significantly before 12 months of age, with better control of regurgitation and improved stomach-emptying with a more upright posture.
When to see your paediatrician
If your child’s GORD symptoms are either frequent or severe, it is recommended that you see a paediatrician to help make a diagnosis and discuss potential interventions.
Examination and treatment
The severity of the condition is one of the key determining factors when it comes to GERD in children. After assessing symptoms and their seriousness, paediatricians may advise parents to have a child make lifestyle changes, including;
- Losing weight
- avoiding carbonated beverages
- eating smaller meals
- elevating the head when sleeping
- avoiding eating before bedtime
- avoiding foods which are high in fat
- avoiding spicy foods
- avoiding eating large meals before exercise
- and avoiding tight-fitting clothes.
Medications prescribed to children with GERD work to help reduce the volume of stomach acid. These can include antacids, histamine-2 blockers, and proton pump inhibitors.
Given the ongoing debate regarding the suitability of these medications for young children, lifestyle modifications can be the preferred mode of treatment. Surgery is typically only considered in the case of serious complications.