Symptoms

You need to take your baby to a doctor for a proper diagnosis if you think they may have gastric reflux.


SYMPTOMS MAY INCLUDE:

  • Chronic COUGHING.

  • SORE EARS or ear infections (Most of these are viral, but in those children that have other symptoms of reflux and frequently require antibiotics for these infections, they might be due to reflux also.)

  • May be DISTRESSED during or after FEEDING. ARCH their BACK in an attempt to relieve their pain or REFUSE to FEED. Others may COMFORT FEED (gorge constantly) and be unhappy unless feeding, and therefore have HUGE WEIGHT GAINS. Most gain weight well, but a few will FAIL to THRIVE (have a slow weight gain.)

  • GAGGING.

  • CAN BE HAPPY when DISTRACTED (making the parent feel like a fraud when their constantly upset baby smiles and babbles throughout the consultation with the doctor!)

  • Frequent Hiccups.

  • IRRITABILITY – may include SCREAMING, WHINGING, CRYING, FUSSINESS and will be inconsolable at times due to PAIN. Irritability is more common during or after feeding, or when laid down. Crying may start quite suddenly especially after hiccups and burps, or may be constant/almost constant. Parents and Health Professionals may suspect colic but the irritability does not follow a regular pattern such as colic does. A baby with reflux may have colic also, which confuses matters. If you consider your baby’s crying to be excessive seek medical help.

  • OVER-SENSITIVITY to NOISE due to tiredness.

  • Restlessness.

  • Some may hold their head to one side in an unusual position to ease their discomfort – SANDIFER SYNDROME is the term used to describe this.

  • May SLEEP LITTLE and be disturbed easily when sleeping. May WAKE FREQUENTLY at night but it is not uncommon for babies with reflux to sleep through the night due to exhaustion.

  • SPILLING or VOMITING (may be projectile, and may vomit through their nose). These may lessen as they sit up and increase when they crawl. May occur at any time including right up until the next feed.

  • DIFFICULTY SWALLOWING

  • Frequent UPPER RESPIRATORY INFECTIONS (coughs or runny noses) and/or frequent SORE THROATS. (All children have their fair share of these and most are viral, but in those children that have other symptoms of reflux and frequently require antibiotics for these infections, they might be due to reflux also.)

  • CHANGE in VOICE.

  • Chronic WHEEZING.


MEDICAL ADVICE AND HELP – More serious symptoms

If your baby has any of the symptoms on the list above in bold type please seek medical advice. Urgent medical help should be sought if any of the following occur in relation to gastric reflux:

  • Has difficulty BREATHING, is breathing faster than normal, stops breathing (apnoea), is grey or blue tinged in colour, is making grunting sounds when breathing, has decreased muscle tone (floppy) or decreased responsiveness.

  • Refuses to DRINK or drinks less than half of their normal fluid intake over a 24 hour day, has less than four wet nappies in 24 hours, or goes six hours without a wet nappy.

  • Has a HIGH TEMPERATURE (above 38.3°c, or if baby is under three months of age).

  • VOMITING is frequent and the baby fails to have four wet nappies in 24 hours or goes six hours without a wet nappy, becomes lethargic, difficult to rouse from sleep or if skin is mottled in colour. Vomit contains blood or coffee ground like material).

Always seek medical help if you are concerned about your child or yourself.


OTHER CLUES THAT GASTRIC REFLUX DISEASE MIGHT BE THE PROBLEM:

  • Many babies, especially very sleepy ones DO NOT SHOW any pain/discomfort until UP TO THREE MONTHS of age.

  • Reflux may be HEREDITARY (mother, father or siblings may have had/do have reflux).

  • About one third of infants with reflux will also have a MILK ALLERGY/intolerance.

  • Reflux is more common in PREMATURE babies.

  • The SEVERITY of SYMPTOMS may vary at different ages.

  • Symptoms may appear to WORSEN when the baby has a cold, virus, teething, infection, or allergies.

  • PARENTS MAY HAVE A GUT FEELING THAT THEIR CHILD IS IN PAIN, SO IF YOU ARE CONCERNED SEEK MEDICAL HELP.


REFERENCES:
V.I.S.A’s “When to especially seek medical advice”.
Treasures® Baby Book
Well Child, Tamariki Ora, Health Book
ACKNOWLEDGMENTS:
Rochelle Wilson (President of GRASP).

Written by Jennifer Howard (National Coordinator 2001 – 2013) and Roslyn Ballantyne (RN) (National Coordinator) for © Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust 2004.

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.

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