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Treatments and drugs
By Mayo Clinic staffMost cases of infant acid reflux clear up on their own. Treatment may include:
- Feeding technique changes. Smaller, more frequent feedings, interrupting feedings to burp, or holding your baby upright during and after feedings may be all that's needed to ease infant acid reflux. If you're breast-feeding, your baby's doctor may suggest that you eliminate dairy products or certain other foods from your diet. If you feed your baby formula, sometimes switching brands helps.
- Medication. If your baby is uncomfortable, your pediatrician may prescribe infant doses of medications commonly used to treat heartburn in adults. Choices may include H-2 blockers, such as cimetidine (Tagamet) or ranitidine (Zantac), or proton pump inhibitors, such as omeprazole (Prilosec) or lansoprazole (Prevacid). It's important to note that otherwise healthy children taking these medications may face an increased risk of certain intestinal and respiratory infections. In addition, prolonged use of proton pump inhibitors has been linked to an increased risk of fractures of the hip, wrist and spine in adults.
- Alternative feeding methods. If your baby isn't growing well, higher calorie feedings or a feeding tube may be recommended.
- Surgery. Rarely, the muscle that relaxes to let food into the stomach (the lower esophageal sphincter) must be surgically tightened so that less acid is likely to flow back into the esophagus. The procedure, known as fundoplication, is usually reserved for the few babies who have reflux severe enough to interfere with breathing or prevent growth. Although surgery can reduce GERD symptoms, the complications are potentially serious — including persistent gagging during feedings.
References
- Tighe MP, et al. Managing gastro-oesophageal reflux in infancy. Archives of Disease in Childhood. 2010;95:243.
- Gastroesophageal reflux in infants. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/gerdinfant/gerdinfant.pdf. Accessed June 22, 2010.
- Winter HS. Gastroesophageal reflux in infants. http://www.uptodate.com/home/index.html. Accessed June 22, 2010.
- Vandenplas Y, et al. Pediatric gastroesophageal reflux clinical practice guidelines: Joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). Journal of Pediatric Gastroenterology and Nutrition. 2009;49:498.
- Sondheimer JM, et al. Gastrointestinal tract. In: Hay WW, et al. Current Diagnosis & Treatment: Pediatrics. 19th ed. New York, N.Y.; McGraw-Hill: 2009. http://www.accessmedicine.com/content.aspx?aID=3403837. Accessed June 18, 2010.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. June 24, 2010.
- FDA Drug Safety Communication: Possible increased risk of fractures of the hip, wrist and spine with the use of proton pump inhibitors. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm213206.htm. Accessed August 4, 2010.
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