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Gastroesophageal Reflux In Children


Gastroesophageal reflux (GER) occurs when food, liquid, or acid from your child's stomach backs up into his esophagus. GER often occurs when the lower muscle (sphincter) of your child's esophagus does not close properly. The sphincter normally opens to let food into the stomach. It then closes to keep food and stomach acid in the stomach. If the sphincter does not close properly, food and stomach acid may back up (reflux) into the esophagus.



Your child may need any of the following:

  • Histamine type-2 receptor blocker: This medicine group is also called H2 blockers. They block acid production in your child's stomach.
  • Proton pump inhibitor (PPI): This medicine blocks acid from forming in your child's stomach.
  • Antacids: This medicine decreases the stomach acid that can irritate your child's esophagus and stomach.
  • Prokinetic medicine: Prokinetic medicine decreases 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.
  • Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.

Follow up with your child's healthcare provider as directed:

Talk to your healthcare provider about any new or worsening symptoms your child has during your follow-up visits. Your child may need a follow-up endoscopy to check if his esophagus is healing. Write down your questions so you remember to ask them during your visits.

Help manage your child's symptoms:

  • Keep a diary of your child's symptoms: Write down when your child becomes fussy, cries for no reason, or has trouble sleeping. Write down what your child is doing when symptoms occur. Bring the diary to your child's follow-up visits. The diary may help his healthcare provider plan the best treatment for him.
  • Feed your infant thickened or special formula: Thickening your infant's milk or formula may decrease how often he vomits. Rice-cereal can be added to your infant's feeding to make it thicker. 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. Laying your infant on his left side after he eats may also help decrease his risk for reflux.
  • Have your child sleep on his left side with his head raised: This may decrease his reflux while he sleeps. The head of your child's bed can be raised by placing pillows or blocks under his mattress.
  • Help your child make good food choices: If your child is overweight, his risk for GER increases. Spicy foods, chocolate, and drinks with caffeine should be avoided. Make sure your child knows that staying away from certain foods may help him feel better. Ask about the best food choices him.
  • Keep your child away from cigarette smoke: Do not smoke or 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.

Contact your child's healthcare provider if:

  • Your child becomes more irritable or fussy and does not want to eat.
  • Your child becomes weak and urinates less than normal.
  • Your child is losing weight when he should not be.
  • Your child has a fever.
  • Your child has more trouble swallowing than he has before, or he feels new pain when he swallows.
  • Your child suddenly has headaches or feels dizzy.
  • Your child has nausea or changes in his bowel movements after he takes his medicine.
  • You have questions about your child's condition or care.

Return to the emergency department if:

  • Your child suddenly stops breathing, begins choking, or his body becomes stiff or limp.
  • Your child's skin turns blue or very red.
  • Your child suddenly has trouble breathing or makes new noises when he breathes.
  • Your child vomits more blood than he has before, or he vomits blood for the first time.
  • Your child has severe chest pain.
  • Your child has severe stomach pain and swelling.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.