New parents worry when their little one has reflux with frequent regurgitation. But it is a normal phenomenon, explains Professor Maurizio de Martino of the Meyer Pediatric Hospital in Florence. And he says: no treatment is needed, as the baby grows and begins to take solid foods and is more often in an upright or sitting position, the regurgitation disappears by itself.
The gastroesophageal reflux, accompanied or not by regurgitation, is a completely physiological phenomenon in infants, which does not require any treatment. To clarify the subject (and avoid giving children medicines when they are not needed!) We asked some questions to Professor Maurizio de Martino, director of the Department of Sciences for the Health of Women and Children of the University of Florence – Pediatric Hospital Anna Meyer.
In this article
Gastroesophageal reflux and regurgitation: difference
Gastroesophageal reflux is the passage of gastric contents into the esophagus; the regurgitation is the same phenomenon, the difference is that the reflux is not seen, while we speak of regurgitation if with the reflux some of the gastric contents also comes out of the mouth.
Why do babies often regurgitate?
Various factors are involved in favoring regurgitation in newborns: first of all theirs supply, which is mainly (or exclusively) liquid, and then the fact that they are almost always in a lying position; in infants, moreover, there is a certain immaturity of the cardia, the valve that connects the stomach to the esophagus and which has the task of preventing the ascent of food from the stomach.
Should gastroesophageal reflux be considered a disease?
It’s time to debunk this ‘urban legend’: reflux is not a disease, but a normal physiological process that occurs in practically all children and adults, especially after meals, without causing any disturbance. There are many very healthy children, who just because they have reflux are treated with pump inhibitors and other antacids, with all the costs, hassles and possible side effects that follow: nature has put an acid pH in the stomach to defend the ‘body; eliminating this useful and beneficial acidity for no reason can only be harmful
What to do then if the child has reflux with frequent regurgitation?
Precisely because it is not a disease, reflux does not need to be treated in any way. At most, if the baby is nursing formula milk, the pediatrician may recommend thickened milk. If, on the other hand, he is breastfed, absolutely nothing must be done, but calmly continue breastfeeding. For the rest, you just have to wait: as the child grows, begins to take solid food and is more and more often in an upright or sitting position, the phenomenon becomes less and less evident and the regurgitation disappears by itself.
Some practical advice to prevent regurgitation
If the baby is regurgitating frequently, you can try to keep him in for some time upright position, at least until he burps; another trick may be to take a break from time to time during the feed. And of course arm yourself with patience and… bibs!
Can gastroesophageal reflux become a disease?
Only in extremely rare cases, which can really be counted on the fingers of one hand. According to the recent joint guidelines of the American and European pediatric gastroenterology societies, we cannot speak of gastroesophageal reflux disease even in children with recurrent vomiting (vomiting, not regurgitation!) And poor growth. Nor can reflux be thought of if the child is particularly irritable or has inexplicable crying. In these cases it will be the pediatrician, through the stories of the parents and an accurate visit, to evaluate whether it is necessary to deepen the investigations to exclude other causes or if, possibly, to refer the child to a pediatric gastroenterology center.
What complications can reflux disease give?
Only in rare cases, and mostly in children with severe neurological problems, can reflux cause recurrent pneumonia and interstitial lung disease, due to aspiration of gastric contents from the lungs. However, there is no scientific evidence that chronic cough, sinusitis, chronic otitis, redness of the pharynx or deafness are determined by reflux.