Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.
Diet and Lifestyle Changes
In many cases, diet and lifestyle changes can help to ease GERD. Talk with your child’s healthcare provider about changes you can make. Here are some tips to better manage GERD symptoms.
- After feedings, hold your baby in an upright position for 30 minutes.
- If bottle-feeding, keep the nipple filled with milk. This way your baby won’t swallow too much air while eating. Try different nipples. Find one that lets your baby's mouth make a good seal with the nipple during feeding.
- Adding rice cereal to feeding may be helpful for some babies.
- Burp your baby a few times during bottle-feeding or breastfeeding. Your child may reflux more often when burping with a full stomach.
- Watch your child's food intake. Limit fried and fatty foods, peppermint, chocolate, drinks with caffeine such as sodas and tea, citrus fruit and juices and tomato products.
- Offer your child smaller portions at mealtimes. Add small snacks between meals if they are hungry. Don’t let your child overeat. Let your them tell you when they are hungry or full.
- If your child is overweight, contact their provider to set weight-loss goals.
- Serve the evening meal early, at least three hours before bedtime.
Other things to try:
- Ask your child's provider to review your child’s medicines. Some may irritate the lining of the stomach or esophagus.
- Don’t let your child lie down or go to bed right after a meal.
- Always check with your baby’s provider before raising the head of the crib if they have been diagnosed with gastroesophageal reflux. Place all babies, including babies with GERD, on their backs for all sleeping until they are 1 year old. This is for safety reasons and to reduce the risk for SIDS and other sleep-related infant deaths.
Medicines and Other Treatments
Your child’s healthcare provider may also recommend other options.
Your child's provider may prescribe medicines to help with reflux. There are medicines that help reduce the amount of acid the stomach makes. This reduces the heartburn linked to reflux. These medicines may include:
- H2-blockers. These reduce the amount of acid the stomach makes by blocking the hormone histamine. Histamine helps to make acid.
- Proton pump inhibitors. These help keep the stomach from making acid. They do this by stopping the stomach's acid pump from working.
The provider may prescribe another type of medicine that helps the stomach empty faster if it's clear that your child has a stomach-emptying delay. If food doesn’t stay in the stomach as long as normal, reflux may be less likely to occur.
Some babies with reflux can’t gain weight because they vomit often. If this is the case, your child's healthcare provider may suggest:
- Adding rice cereal to baby formula
- Giving your baby more calories by adding a prescribed supplement
- Changing formula to milk- or soy-free formula if your baby may have an allergy
In some cases, tube feedings may be recommended. Some babies with reflux have other conditions that make them tired. These include congenital heart disease or being born too early (premature
). These babies often get sleepy after they eat or drink a little. Other babies vomit after having a normal amount of formula. These babies do better if they are constantly fed a small amount of milk.
In both of these cases, tube feedings may be suggested. Formula or breastmilk is given through a tube that is placed in the nose. This is called a nasogastric tube. The tube is then put through the food pipe or esophagus, and into the stomach. Your baby can have a tube feeding in addition to a bottle feeding. Or a tube feeding may be done instead of a bottle feeding. There are also tubes that can be used to go around, or bypass, the stomach. These are called nasoduodenal tubes.
In severe cases of reflux, surgery called fundoplication may be done. Your baby’s provider may recommend this option if your child is not gaining weight because of vomiting, has frequent breathing problems, or has severe irritation in the esophagus. This is often done as a laparoscopic surgery. This method has less pain and a faster recovery time. Small cuts or incisions are made in your child’s belly. A small tube with a camera on the end is placed into one of the incisions to look inside. The surgical tools are put through the other incisions. The surgeon looks at a video screen to see the stomach and other organs. The top part of the stomach is wrapped around the esophagus. This creates a tight band. This strengthens the LES and greatly decreases reflux.