GERD

Some babies have a severe reflex which causes them a lot of discomfort and pain. Their spit-ups are usually more frequent and larger in quantity. It may involve occasional projectile vomiting as well.
Susceptible population:

• Babies with a family history of GERD
• Babies with other health problems
• Preemies (as their digestive system is more immature than full-term babies)

GERD usually improves by 1-2 years of age.

Symptoms :
GERD has similar symptoms to mild reflux but are more intense in nature. They show up more often and cause more discomfort. Some of the common symptoms are as follows.

• Frequent spit-ups that may be painful
• Gagging and choking
• Coughing
• Frequent hiccuping
• Bad breath
• Noticeable discomfort in lying down
• Interrupted and poor sleep

Some babies may have more severe symptoms which are as follows.

• Excessive fussiness and inconsolable crying due to pain
• Poor weight gain and sometimes even weight loss
• Difficulty in feeding or swallowing
• Persistent nasal congestion and cough
• Frequent ear infections
• Spitting up green/yellow fluids, sometimes with traces of blood
• Arching of the neck and back to relieve pain
• Breathing issues like wheezing, aspiration, asthma, bronchitis, pneumonia etc

Some babies may also have ‘Silent GERD’. This is tricky because there are no spit-ups in this condition. The content from the stomach comes up only till the esophagus and is swallowed back. Even though there is absence of spit-ups or vomits, it is painful for the baby. Other accompanying symptoms include gagging, choking, bad breath, very frequent hiccuping, chronic coughing, excessive fussiness and poor sleep.

Treatment :
It is recommended that a baby with GERD should be considered for medical treatment only if she is facing severe symptoms including poor weight gain or weight loss, severe choking and other breathing complications. However, if a baby is suspected with GERD, usually doctors prescribe various reflux medicines (without running any tests) to see if they improve the baby’s symptoms. Another recommendation is to screen the baby for other allergies as they involve similar symptoms. One of the examples of such allergies is – cow’s milk protein allergy (CMPA).

Other Helpful Measures :

• Frequent breastfeeding helps keep nursing sessions small. And smaller, frequent nursing enables easier digestion.
• Upright nursing position for the baby helps.
• Nursing in a tub filled with warm to hot water can calm the baby.
• Lots of skin to skin helps a lot when the baby is particularly fussy and is rejecting the breast.
• Comfort suckling should be encouraged as it speeds up the process of emptying of the stomach.
• Ensuring no smoking or smokers around the baby.
• Mother could eliminate caffeine from her diet as it can worsen the baby’s reflux.
• Avoiding to press the baby’s abdomen area and keeping the baby in loose clothing can help comfort the baby.
• Babywearing can soothe the baby as well as keep the baby in an upright position.
• Lying the baby down on her left side significantly reduces reflex. However, it is extremely important to understand that it should be done only when the baby is awake and when the baby can be continuously monitored by a vigilant adult.

References:
https://www.llli.org/breastfeeding-info/gerd/
https://kellymom.com/hot-topics/reflux/