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.”
http://www.treasures.co.nz/Explore-your-stage/Article/?contentId=1784920 These won't work if your child is unwell or in pain, but are otherwise good tips.
Sleeping through the night At this age and stage research by Dr Marc Weissbluth indicates that hunger is no longer why your baby is waking at night if they are a healthy weight and continuing to gain weight we can teach them to sleep from 7pm-7am. Your baby needs to be eating a healthy diet of carbo…
Hi everyone, It has been pointed out that new posts to the page by non-admin don't show up in your newsfeed. I don't want to repost them, but if you want to pop on over and share your experiences there are a few new posts from October.
Please do not advertise on our page. This is for sharing our experiences about Infant Reflux/GOR/GORD. If you would like us to link to your organisation or your page, please message the page. The GRSNNZ Committee will make the decision once you have provided us with information on the Governance of the Organisation, Source of your Information or your relevant NZ Health or Nutrition Qualification etc. Grumble over...
https://www.healthed.govt.nz/system/files/resource-files/HE2309.pdf Cool pictures, lovely mothers. Not saying that women who choose to bottle feed aren't wonderful mothers too, but this is neat promotion.
Hi there. Posting from the UK. Wanted to share our story to gain some more insight. We've had a really tough time. My first baby is 8 + weeks now and we've had no end of issues. She was tongue tied..snipped...but latch still a problem. She is mostly breastfed but using nipple shields. Occasional top up when i can't tolerate feeding her. She feeds or wants to feed constantly. Thought it was hunger but no different after a bottle of formula. Anyway...a friend mentioned she could have silent reflux...symptoms are constant feeding hand sucking...back arching fussing through feeds like she wants it but doesn't too. Struggles to sleep although sooo tired. Falls asleep on boob but wakes immediately after. Hiccups a lot. Sneezes a lot. Crys after feeds...weight has been slow to gain tho. Prescribed infant gaviscon...any experiences of this and is it likely to make her constipated if mostly breastfed?! Worried it feels like trial and error at her expense. She's so unsettled and we are really struggling....opinions welcome :)
The Cards are now available in an app for Android and Apple devices: http://allright.org.nz/our-projects/tiny-adventures/
Our Pack of Tiny Adventures was developed to help parents to enjoy quick, fun and affordable activities with their children. It was developed in partnership with SKIP (Strategies with Kids Information for Parents) gives parents easy ways to connect with their kids - even if they only have a few min…
My 12 week old baby has reflux, currently on 5mg of losec in the morning novelac reflux formula, she also suffers with painful wind, lately she has been choking on her vomit, not sure if I should change to novo lac colic formula instead, we have tried soy and goats to which she spewed up a lot more than the ar formula, please help with suggestions , it is hugely stressful for our family
Cn u get formula made for babies with reflux on script?
I'm getting the September Newsletter ready. Is there anything anyone wants to contribute? Please let me know: https://www.facebook.com/roslyn.ballantyne.rn
Hi there are there any formulas that you can get on prescription or financial assistance? Pretty sure my 8 week old isn't coping with his formula that he's on. He has reflux and on ranitidine but now he has green mucousy poo so im thinking he might need some different formula? But I see specialist formulas are expensive!!
Hi, my 5 month old has started solids and we have been ok'd to feed these before milk as otherwise he spills most of it. He takes losec granules, which was have been giving with pear 30mins before a milk feed. Can we now just give these with his solids with milk following half an hour+ later? Or not due to the higher volume of food in his stomach so it wouldn't be digested by the time he has his milk. Thanks
Hi. We've used the karicare thickener in our boys bottles on top of losec and neocate to control his reflux. Now he's 4 months old I was looking at using watties rice cereal to thicken his bottles before moving to solids at 6 months. Looking to find anyone who thickens with rice cereal. Advice? Thank you
Argh! I don't know if I'm doing the right thing for my wee girl. We discovered her reflux early 8 days old and has been on goats milk formula for 3 months. Did it help? Hard to say but she was happy enough. We were reffered to the hosp dietician by our plunket nurse and on Thursday started neocate. Its made things worse and she seems in pain.. her poops are slimy green. We gave her a few gaviscon feeds with it to help her tum cos she seems to have a sore tummy a lot. So its Sunday, we've been on it three days but I am continually second guessing myself. Should we have seen a change in her by now. Is it normal to take a few days for the tummy to get used to it? I hate putting her through all this esp if it doesn't end up working... sometimes I just want to throw it in and put her back on goats milk... would love some advice from others on neocate or just any advice/encouragement please and thank you :)
Hi mums I have recently taken my daughter off losec on advise from a paed to see how she went. We didn't notice the symptoms coming back and also started solids around same time with it going great. She's had a cough and cold but is over it except this nagging cough which is day and night until she eventually throws up. My question is could the cough actually be the reflux and should I start losec again.
A Good News Story ... http://www.cryingoverspiltmilk.co.nz/his-gastric-reflux-stopped/
Hi Roslyn, Thanks for the updates over the past several months. I am leaving the group as my little boy no longer suffers from gastric reflux and is also no longer dairy intolerant! FYI he was on Neocate from 3 months old and had a combination of formula and my milk until he was 7.5 months. ...