Q & A: I think my baby has reflux

I suspect my baby has reflux. What should I be looking for? Are there treatments for reflux aside from the standard prescription or over-the-counter medications?

For newborns the common signs of reflux may include vomiting (especially after meals), irritability, arching of the body, gagging, choking, food aversion, head turning, and failure to thrive. You may also want to consider reflux if your baby appears uncomfortable in a bucket car seat, especially if s/he starts screaming as soon as they are put in the seat.  When your baby is placed into the car seat it shapes the body into a c shape, increasing abdominal pressure and forcing food contents back up into the esophagus causing pain (and hence the screaming).  If your baby calms when held upright in the arms, sling, or baby carrier s/he may also have reflux, as this position decreases abdominal pressure and relieves pain associated with regurgitating food. if you have an older child they may complain of abdominal or chest pain as well as regurgitation of food.  Unfortunately, there is no definitive test for reflux and it is often a diagnosis of exclusion, meaning other conditions have been ruled out as causative factors and reflux is what is left as a diagnosis.  The above signs and symptoms taken alone can be associated with many conditions, not just reflux, so it is important to look at the whole picture or totality of your child’s health, and not just individual symptoms and signs.

There are many treatment options for reflux in both the infant and older child aside from the common prescription and over-the-counter medications.  It is important to keep in mind these medications do come with side effects and risks, especially in infants whose metabolism and detoxification systems are still immature.  Safety testing is usually done in adults and therefore we are still not sure of the safety profile of these medications in infants and small children.  Food sensitivities should be a primary area of investigation for suspected reflux. If your baby is exclusively breastfed, your diet will need to be assessed to get positive results and improvement in your baby.  Ensuring a healthy intestinal flora by supplementing with age appropriate probiotics can also help with relieving reflux.  Many herbal and homeopathic options are safe for use in infants, children, and breastfeeding women.  Herbs and homeopathics, although natural, should be used under the strict supervision of a qualified and licensed health professional.

Have a question for Dr. Carly? Email her.