Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) (Child)

• Poor weight gain or weight loss
• Fussy and irritable during or after feeding
• Frequent back arching because of discomfort
• Milk refusal or poor feeding
  

Management of Infants with GER or GERD

1. Adequate Burping
   Burp the infant well in the middle of feeding and after feeding.
   
   
   
   
2. Proper positioning
   After feeding, caregivers can carry the infant in an upright position. You can also support and place the infant’s head and upper chest higher than the level of his stomach to keep the milk feeds in the stomach. This can be done by placing the infant’s head and upper back on a small pillow (or folded towels).
   
   
   
   
3. Avoid Overfeeding
   Overfeeding may distend the stomach and increase the risk of reflux. Please consult your friendly healthcare providers for your child’s recommended milk feed volume and frequency. A smaller volume of milk feeds, given at more frequent intervals may be recommended to reduce reflux symptoms.
   
   
4. Trial of Anti-reflux formula milk.
   Your child’s physician may recommend a trial of anti-reflux formula (thickened formula milk) to reduce the frequency of reflux symptoms.
   
   

Investigations and treatment of GERD

Diagnostic tests include 24-hour pH impedance monitoring and upper gastrointestinal contrast study. These tests may be recommended after consultation with the gastroenterologist.

Anti-reflux medications may be prescribed for infants with persistent reflux symptoms. These medications help to reduce gastric acid production (e.g. omeprazole) and increase gut movement (e.g. Domperidone). These medications are administered 30-60mins before milk feeds for optimal effect.

In severe and complicated cases of GERD, surgical procedures may be required.

Follow-up Appointment

A follow-up appointment may be warranted to review your child’s reflux symptoms, growth, and development. Please keep to the follow up appointment as advised by your friendly doctors.