Gastroesophageal Reflux In Children

WHAT YOU SHOULD KNOW:

• Gastroesophageal reflux (GER) occurs when food, liquid, or acid from your child’s stomach backs up into his esophagus. The esophagus is a tube that carries food and liquid from the mouth into the stomach after swallowing. There is a sphincter (tight band of muscle) at the end of the esophagus that opens to let food into the stomach. This sphincter then closes to keep the food, liquids, and stomach acid in the stomach. If the sphincter does not stay closed, food, liquids, and stomach acid may reflux (back up) into the esophagus. When your child has GER, he may not want to eat or drink and he may lose weight. His esophagus may swell and he may have problems swallowing. Your child may also be at higher risk of having lung or upper airway infections.
  
  
• If your child's GER is severe (very bad) he may be at risk for gastroesophageal reflux disease (GERD). Ask your child’s caregiver for more information about GERD. Tests to look at your child's esophagus and stomach may be needed to check for GER. Your child may also have tests done to check the acid in his stomach. Some children with GER will outgrow it and may not need treatment. Your child may also need medicines or surgery to treat his GER. Treatment for GER may be needed to prevent stomach acid from damaging the esophagus. Treatment may also make it easier for your child to swallow so he can get enough nutrition to grow.

INSTRUCTIONS:

Your child's medicine:

• Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  
  
• Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  
  
• Acid reducers: Acid reducers work by decreasing the amount of acid your child has in his stomach.
  
  
• Prokinetic medicine: Prokinetic medicine works to decrease the amount of time food stays in your child's stomach. When your child's stomach empties properly, he may have a decreased risk for reflux.

Follow-up visits:

If your child needed antireflux surgery he may need a follow-up visit to check his wound. Talk to your caregiver about any new or worsening symptoms your child has during your follow-up visits. Tell your caregiver if you do not think treatments are working to help resolve your child's GER. Your child may need a follow-up endoscopy to check if his esophagus is healing. Keep all appointments. Write down any questions you and your child may have. This way you will remember to ask these questions during your child's next visit.

Ways to help a child with GER:

• Keep a diary of your child's symptoms. Write down when your child becomes fussy and cries for no reason. Also write down when your child has trouble sleeping at night. Write down what your child is doing, or if he has just eaten when symptoms occur. Bring the diary to your child's visits with his caregiver. The diary may help your child's caregiver plan the best treatment for him.
  
  
• Feed your infant thickened or special formula. Thickening your infant's milk or milk formula may decrease how often he vomits. Rice-cereal can be added to your infant's feeding to make it thicker. Ask your child's caregiver for more information about thickening products. You may also try to feed your child hypoallergenic milk formula to decrease GER. Smaller feedings more often may also help decrease your infants GER.
  
  
• Position your infant after feedings to decrease his symptoms. After feeding your infant, keep him sitting upright for 90 minutes to decrease GER. You may also lay your infant on his stomach with his head slightly raised after he eats. Only lay your infant on his stomach while he is awake. Letting your infant sleep on his stomach may increase his risk for sudden infant death syndrome (SIDS). Laying your infant on his stomach helps decrease GER by decreasing the pressure on his stomach. The head of his bed can be raised by rolling blankets and placing them under his mattress. Laying your infant on his left side after eating may also help decrease his risk for reflux. Ask your caregiver for more information about positions that may decrease GER.
  
  
• Have your older child sleep on his left side with his head raised. Having your child sleep on his left side with his head raised may decrease his reflux while he sleeps. Your child may sleep better and his stomach may empty easier. The head of your child's bed can be raised by placing pillows under his mattress. You may also use bed raising blocks.
  
  
• Help your child make good food choices. If your child weighs more than he should for his height, his risk for GER increases. Spicy foods, chocolate and drinks with caffeine should be avoided. Caffeine is often found in coffee and colas. Make sure your child knows that staying away from certain foods may help him feel better. Talk to your child's caregiver about the best food choices him.
  
  
• Keep your child away from cigarette smoke. If you smoke, do not smoke around your child. Do not allow others to smoke around your child. If your child smokes, help him to stop. Smoking can worsen your child's GER and harm his heart, lungs, and blood. Talk to your child's caregiver if he needs help to stop smoking.
  
  
• Make sure your child does not drink alcohol. If your child drinks alcohol, his GER may worsen. Alcohol is found in beer, wine, whiskey and other adult drinks. Alcohol can also damage his brain, heart, and liver. Almost every part of your child's body can be harmed by alcohol. Talk to your child's caregiver if he drinks alcohol, and ask for information about how to help him stop.

CONTACT A CAREGIVER IF:

• Your child becomes more irritable or fussy, and does not want to eat.
  
  
• Your child becomes weak and is urinating less than what is normal for him.
  
  
• Your child is losing weight when he should not be.
  
  
• Your child has a fever (high body temperature).
  
  
• Your child has more trouble swallowing than he has before, or feels new pain when he swallows.
  
  
• Your child suddenly has headaches or feels dizzy.
  
  
• Your child has nausea (upset stomach) or changes in his bowel movements after taking his medicine.
  
  
• You have questions or concerns about your child’s condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

• Your child suddenly stops breathing, begins choking, or his body becomes stiff or limp.
  
  
• Your child's skin turns blue in color or very red.
  
  
• Your child suddenly has trouble breathing or is making new noises when trying to breathe.
  
  
• Your child vomits more blood than he has before or he vomits blood for the first time.
  
  
• Your child has yellow, green, or foul smelling drainage from his wound.
  
  
• Your child has very bad chest pain.
  
  
• Your child has very bad stomach pain and swelling.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Gastroesophageal Reflux In Children (Aftercare Instructions)