Our 2-month-old baby cries a lot and the doctor has diagnosed reflux and given an antacid. The baby vomits a lot and seems unhappy but is growing satisfactorily. Can you explain reflux to me?
The full name for this condition is Gastro-oesophageal-reflux. Other kinds of reflux can occur elsewhere in the body. I don’t blame your doctor for using the shortened name and I will too for this answer. In this condition stomach contents pass back up (reflux) from the stomach into the gullet (oesophagus).
Such reflux is common in babies as they take a large quantity of fluid for their size. If an adult was to take the same amount of fluid per kilogram body weight, he/she would drink 7 + litres per day.
This huge intake of fluid puts a lot of pressure on the valve-like mechanism that normally stops fluid from passing from the stomach and back into the gullet. Forty percent of babies vomit after feeds because of this reflux and in most cases it does not cause a problem. There are 3 complications of reflux that do cause problems:
The acid made in the stomach may cause irritation to the lower part of the gullet. This is painful and makes the baby irritable. It seems this is what your doctor suspects.
The refluxed stomach contents may come up to the point where the gullet and the windpipe branch of the lower throat. This causes a potential for those contents to be inhaled. The first part of the windpipe has a trapdoor (epiglottis) which closes when we are eating, vomiting or refluxing. If this fails then we can inhale the refluxed material causing chest disease. This is quite rare in normal babies – only 1 in 500 refluxing infants have this complication.
The baby may bring back so much of his/her milk, that not enough is consumed. This would make the baby hungry and demanding. After some time growth would be noted to be inadequate. This complication is extremely rare- in 40 years of paediatric practice, I don’t think I have ever seen it.
Reflux disappears spontaneously as the baby drinks less per kilogram and adopts the upright position. The average age of it stopping is 10 months but there is a wide range of ages at which it stops. Most adults have occasional episode of reflux when we are aware of fluid coming back up into our throats – we just swallow it and do not worry.
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