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Acid reflux is extremely common in infants and usually resolves in the first year. For these children, conservative treatment is all that is needed. Small frequent feeds, thickened feeds and positioning the infant to minimise reflux are measures used.

However, true GERD in children, although uncommon, warrants investigations. Before considering investigations, it is important to exclude other potential causes of vomiting in infants. These include cows’ milk protein allergy, infections and systemic conditions that can cause vomiting.

The common investigations done are endoscopy with biopsy and 24 hour pH monitoring of the esophagus. The symptoms of GERD in children are a major worry for parents and part of the overall treatment of acid reflux in these cases is reassurance for the parents and families.

Acid reflux commonly starts between four weeks and four months after birth. It is estimated that up to 65% of normal children have acid reflux in the first year. After one year this figure drops dramatically.

True GERD is a serious and distressing condition. The common acid reflux symptom is vomiting. In addition there can be poor weight gain and respiratory symptoms such as persistent coughing. When GERD is severe and reflux reaches the lungs, the child can develop stridor, wheezing and in infants prolonged periods of apnoea.

The prevalence of GERD in children is one in 300 children. In true GERD the lower esophageal sphincter is not functioning well, and medication is necessary to control acid reflux.

Dr. Phil Hariram.