reflux happens when food and stomach acid flow from the stomach back into the
esophagus. The esophagus is the tube that carries food
from the mouth to the stomach. In adults, reflux is often called heartburn or
Reflux is common in babies and children, and it is
usually not a sign of a serious problem. Most babies stop having reflux around
1 year of age. A child who continues to have reflux may need treatment.
Reflux happens because of a
problem with the ring of muscle at the end of the esophagus. The ring of muscle is called the
lower esophageal sphincter, or LES. The LES acts like
a one-way valve between the esophagus and the stomach. When you swallow, it
lets food pass into the stomach. If the LES is weak, stomach contents can flow
back up into the esophagus.
In babies, this problem happens
digestive tract is still growing. Reflux usually goes away as a baby matures.
It is common for babies to
spit up (have reflux) after they eat. Babies
with severe reflux may cry, act fussy, or have trouble eating. They may not
sleep well or grow as expected.
An older child or teen may have
the same symptoms as an adult. He or she may cough a lot and have a burning feeling in
the chest and throat (heartburn). He or she may have a sour or bitter taste in
If stomach acid goes up to the throat or into the
airways, a child may get hoarse or have a lasting cough. Reflux can also cause
wheezing, and it may hurt to swallow.
To find out if a child
has reflux, a doctor will do a physical exam and ask about symptoms. A baby who
is healthy and growing may not need any tests. If a teen is having symptoms,
the doctor may want to see if medicines help before doing tests.
If a baby is not growing as expected or treatment doesn't help a teen,
the doctor may want to do tests to help find the cause of the problem. Common
Most babies stop having
reflux over time, so the doctor may just suggest that
you follow some steps to help reduce the problem until it goes away. For
example, it may help to:
For older children and teens, it may help to:
If these steps don't work, the doctor may suggest
medicine. Medicines that may be used include:
Before you give your child any
over-the-counter medicine for reflux:
Children with reflux rarely need surgery. It may be an
option for babies or children who have severe reflux that causes breathing
problems or keeps them from growing.
The GastroKids website helps parents, children, and teens learn more
about reflux and GERD, celiac disease, inflammatory bowel disease, and other
digestive disorders in children. This website is part of the NASPGHAN Foundation
(North American Society for Pediatric Gastroenterology, Hepatology and Nutrition).
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
This clearinghouse is a service of the U.S. National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the
U.S. National Institutes of Health. The clearinghouse answers questions;
develops, reviews, and sends out publications; and coordinates information
resources about digestive diseases. Publications produced by the clearinghouse
are reviewed carefully for scientific accuracy, content, and readability.
NASPGHAN promotes advances in clinical care, research,
and education for infants, children, and teens with digestive disorders. The
family resources page of this Web site has information about pain in the belly,
diarrhea, constipation, vomiting, poor weight gain, nutritional problems, and
diseases of the liver, bowel, and pancreas.
Other Works Consulted
Horvath A, et al. (2008). The effect of thickened-feed interventions on gastroesophageal reflux in infants: Systematic review and meta-analysis of randomized, controlled trials. Pediatrics, 122(6): e1268–e1277.
Khan S, Orenstein SR (2011). Gastroesophageal reflux disease. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1266–1270. Philadelphia: Saunders.
Kumar Y, Sarvananthan R (2008). GORD in children, search date August 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Orenstein SR, et al. (2009). Multicenter, double-blind, randomized, placebo-controlled trial assessing the efficacy and safety of proton pump inhibitor lansoprazole in infants with symptoms of gastroesophageal reflux disease. Journal of Pediatrics, 154(4): 514–520.
Sundaram S, et al. (2011). Gastroesophageal reflux section of Gastrointestinal tract. In WW Hay et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 595–596. New York: McGraw-Hill.
March 13, 2012
John Pope, MD - Pediatrics
& Chuck Norlin, MD - Pediatrics
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