The baby/child is given a white strawberry flavoured liquid to swallow. For babies this will be administered from a bottle, or through a nasal gastric tube if necessary. An X-ray is taken by a Radiologist (X-ray Doctor), which is projected on a video screen, and then analysed.
This investigation is positive in approximately 50 to 60 percent of babies/children who clinically suggest GOR (gastro-oesophageal Reflux). The examination may demonstrate reflux, the wave pattern in the oesophagus, and the rate of emptying of the stomach. Importantly, this investigation shows whether the anatomy of the oesophagus and stomach are normal and if the baby/child has a hiatus hernia.
Babies/children with GOR may not reflux during the period of the screening, producing a normal reading. A Barium Swallow is therefore not a very reliable test for reflux, as it is possible for a baby/child to have reflux but it not to be picked up by this investigation.
It is common for the Barium preparation to cause constipation, and it should not be left to harden in the bowel. Therefore a laxative may need to be used if constipation is, or becomes a problem. It is useful to take the baby/child’s favourite bottle or cup to administer the barium preparation, as this may make the procedure more acceptable to them.
This investigation involves 15 minutes under a general anaesthetic if the symptoms and signs suggest reflux oesophagitis. The endoscopist (the doctor who performs the endoscopy) is able to assess the degree of oesophagitis (inflammation in the oesophagus), and whether there are any problems in the stomach and duodenum. A biopsy (specimen of the oesophageal lining) may be taken for pathological examination.
Other conditions such as coeliac disease (gluten intolerance), food allergies, lactose and other sugar intolerances, helicobactor pylori etc. can also be diagnosed from appropriate biopsies taken during an endoscopy.
This investigation is also a very important step before surgery is considered.
A probe sensitive to pH changes (thus an index of acidity) is positioned in the oesophagus. This investigation demonstrates the presence, frequency and duration of reflux episodes. For accuracy of result, the probe is left in the oesophagus for 18 – 24 hours, and an X-ray needs to be taken once the probe is in place to confirm it is positioned accurately.
This is a good test for determining whether a baby/child has reflux or not, and the severity of the condition. Several types of readings are taken, but the most crucial one is the % of reflux over 24 hours. In general: – under 5% is normal, 5 – 10% is mild, 10 – 20% is moderate and over 20% is severe. However, the severity of the condition is no indication of treatment needed e.g. a baby/child with mild reflux may still need Omeprazole, whereas a baby/child with severe reflux may remain well controlled on Zantac.
Diagnosing GER in Children – http://www.medscape.com/viewarticle/742615?src=mp&spon=9 – “The measurement of pH is the predominant modality used to diagnose gastroesophageal reflux (GER) in children. However, pH monitoring provides only part of the answer with respect to whether a child has reflux episodes. Multichannel intraluminal impedance monitoring can measure acidic and nonacidic reflux episodes using pressure-sensing electrodes along the length of the probe.” I haven’t heard of impedance monitoring being used in New Zealand.
© Gastric Reflux Association for the Support of Parents/babies (GRASP) and Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust (GRSNNZ) 2004. Used, edited and added to by GRSNNZ with permission.
Page may be printed or reproduced for personal use of families, as long as copyright and Crying Over Spilt Milk‘s URL are included. It may not be copied to other websites or publications without permission and acknowledgement. This information (unedited) was also provided (by GRASP) to health professionals in New Zealand to use ” to continue to support and inform families with babies/children with Gastro-oesophageal Reflux.”
Baby Sleep Consultant is a nationwide infant and child sleep consultancy service, we offer affordable in home, email or phone consultations. Our methods are science and practice based, whether its establishing healthy sleep habits in your 6 week old, teaching your 9 month old to sleep through the ni...
Hi there, just wanted to say that this page and your website has been a huge help! It has provided ideas, helping me and my 8 week old son cope with his reflux. He was diagnosed @ 4 weeks old, and has been on gaviscon since. I have also gone dairy free, not sure if it's helping but he's definitely settled over the weeks. Hopefully he 'grows out of it' as the Dr says, grateful for all tips and advice from other parents experiencing the same...'I'm not alone'....this is a photo of our son in his Happy Place, where he goes from crying to smiling straight away!
Hi, Just wondering if you could help me with a question please. I got given Losec Suspension today. Since it's in suspension form and not the granules how long before a feeding should I give it to my baby or can it be given at the same time?
My baby has been diagnosed with reflux, her dr prescribed her ranitidine 150 mg/10 ml. It says 1 ml 3x a day, shes 5.7 kgs, does this sound right? That seems alot to me...
Hi there. I've been reading your website and Facebook page with interest over the past few months and it's been really helpful. My daughter is coming up 4 months old and her reflux seems to be improving. We tried gaviscon but it didn't make much difference. Main thing for us has been that I cut dairy out of my diet. I now have food with dairy in it but just don't do the core basics like cheese, yoghurt, milk etc and although she still spills often, the associated pain seems to be almost gone. Am hoping she's growing out of it but the dairy still seems to have a bit of an effect. Anyway, in two months time I have to go back to part-time work and will need to start using a formula on those days. I usually used karicare gold with my kids but have no idea what options would be best for my reflux baby. Can you make some suggestions? I'd like to try some out to see how she reacts etc before I go back to work but don't know what brands to try. Thanks.
Hi, I have a wee girl Matilda, 3.5 months, who has been diagnosed with gerd and is currently on Ranitidine and Domperidone. We have tried Losec and gaviscon infant too, and after trying pepti jnr and neocate we are now on elecare formula. Also have done the usual, raise cot, chiro, upright after feeds etc. We don't seem to be making much progress and its really heart-breaking to try all these medications on such a wee person! We do seem to have 3-4 great days when she is happy and contented but then have 3-4 terrible days with constant crying, not much drinking, so much vomit and terribly unsettled, not much sleeping etc; my question is, is this 'normal' ?! Is gerd cyclonic? Thanks, Amanda :)
My four month old son has recently been diagnosed with reflux after his feeding has become worse and worse over the last month. He will cry before and during a feed and constantly turns his head from side to side. It takes alot of coaxing to get him to drink. He has also started waking almost hourly through the night. We have tried gaviscon which gave him terrible constipation and now ranitidine. After reading the dosages on the spilt milk site we realized the dose we were given was far too low so have now been on a high ish dose for a week with little change. How long should it take to see a change? We also have a script for omeprazole so can try that next. Anyone else with a reflux baby also had these sleeping issues? Any tips welcome, we have raised the bed and keep him upright after feeds. Thanks in advance
Anyone recommend a good paediatrician in Auckland, son has reflux and looking to get some help!
How can I give my omeprazole granules to a 5 month old? I have been putting in pear puree but now want to introduce food and think this is putting her off wanting to eat!
Our membership form is now working again. Sorry for the delay. We are looking forward to meeting some new members. http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz.../ Joining Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust gives access to our Newsletters and Private Local and National Support Networks. Membership is free, and this gives you opportunities to discuss gastric reflux related issues with others in a safe and confidential setting.
hi i have a nearly 8 month old girl, she is on ''Kari-care anti reflux AR'' now they say by six months the reflux or spewing up heaps of milk should be fine now. but im scared to put her on normal kari care cause she use to vomit like crazy, what formula should i be going on? thanks :)