Spit ups

                                      My baby is a happy spitter

In our practice 50 percent of the mothers complain that their babies won't keep their formula down. They cry and most of the times are fussy. Most often these babies also have problems with adequate weight gain and various other problems that may get the parents worried. The spitting up or Gastro esophageal Reflux (GERD) GER occurs often in normal infants. Most infants with GER are happy and healthy even though they spit up or vomit. Spitting up tends to peak at 4 months and most infants stop spitting up by 12 months.                                                                                                 

When is it necessary to treat Gerd?

As long as the baby is gaining weight and is growing well, and has no other medical condition there is no need to treat this condition .However if if you see any of these following signs - It is important to involve your primary care provider.

·         If you see Vomiting associated with

            Blood

           Green or yellow fluid

            Poor weight gain

·         Inconsolable or Severe Crying and Irritability

·         Persistent Food Refusal

     Poor growth or failure to thrive 

·         Breathing Problems

       Difficulty breathing

      Repeat bouts of pneumonia

           Breathing stops

            Turning blue

            Chronic cough

           Wheezing

What tests may be ordered by you doctor?

Depending how severe the reflux is the following may be ordered:

1.  Test for a blood in stool

2. To look for anemia

3. Upper gi series-a type of x-ray to study the baby’s food pipe and the tummy.

4. Ph probe - A test to measure how often stomach contents wash up into the food pipe

However if the baby (0-24 months old) is gaining weight certain conservative measures can be employed;

Smaller frequent feedings should be given.

Frequent burping during feedings.

Avoid using an infant seat after feeds, this may encourage reflux

Changing the formula to a more basic form like nutramigen, allocare ,neocare.

Thickening of the feeds with rice cereal. Prior to this it is advisable to consult your primary care provider.

Role of Medications

If necessary medications may be provided. Two types of medications may be used one that reduces the stomach acid. Another type that shall prevent food from the stomach to go into the food pipe (esophagus). This again should be discussed with your primary care provider

Reflux may occur in older children and adolescents-which may at times require a more extensive work up. However this can also be modified with a conservative approach like

·         To have smaller more frequent meals.

·         Avoid eating 2-3 hrs prior to bed time.

·         Elevating the head of the bed to thirty degrees.

·         Avoiding choclate, carbonated drinks, spicy food and caffeine.

·         Avoiding large meals prior to exercising.

·         Loosing weight if over weight.

·         Avoid exposure to tobacco.

When do you get worried?

If any of the above mentioned worrisome signs are seen along with

·         Sensation of food coming to the back of your throat

·         Discomfort or pain in the stomach and chest

·         Swallowing problems such as

·         Pain while swallowing

·         Discomfort while swallowing

·         Sensation of food getting stuck in the chest

·         Breathing problems along with hoarseness of your voice

Diagnostic testing and treatment

Other than the above mentioned tests  An endoscopy may become necessary depending on the Patient. If the child has been taking acid suppression drugs for more than two months without any relief in the heart burn an upper endoscopy may be required. This allows the Doctor to look directly at the Childs food pie and stomach to check for any abnormality.

Generally acid suppressing drugs may be necessary if symptoms persist even after changes to the lifestyle are made.

Prior to making any of these life style changes it is important to discuss it with your primary care provider. Please feel free to post any comments or questions.

Ritu Walia

Comments

[neena]

Thanks i was going to see my doctor my baby loose weight . Not keeping formula
What can id do for baby
Neena

[anony]

IBS is another medical term by docs who don't know wtf is actually going on with you. So you get a nice little labelled disorder telling you..."you're screwed up and we don't why but we'll give it a fancy name so you don't feel left out."

Whats worse than at a social gathering others are sharing their syndromes, aches and other faulty wirings while you sit on the sideline describing your imbalance is due to ??? the stars not aligning correctly.

ps I actually don't have ibs but the med world is bogus.

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