Infant reflux occurs when food backs up from a baby’s stomach, causing the baby to spit up. Sometimes called gastroesophageal reflux (GER), the condition is rarely serious and becomes less common as a baby gets older. It’s unusual for infant reflux to continue after age 18 months. Reflux occurs in healthy infants multiple times a day. As long as the baby is healthy, content and growing well, reflux is not a cause for concern.
Signs and symptoms
- Bringing up milk or being sick during or shortly after feeding
- Coughing or hiccupping when feeding
- Being unsettled during feeding
- Swallowing or gulping after burping or feeding
- Crying and not settling
- Back-arching
- Having screaming episodes, and being difficult to settle
- Drawing legs up
- Not gaining weight
- Discomfort on lying flat
Causes
- in the first 6 months of life, infants spend much of their time lying down and do not have a fully developed esophagus and lower esophageal sphincter. They also eat meals that are primarily liquid and larger, relative to their body size, than older children or adults do. These factors make it more likely that stomach contents will come back up into the esophagus. As infants spend more time upright, eat more solid foods, and grow and develop, they typically experience less GER.
- Premature birth
- conditions that affect the lungs, such as cystic fibrosis
- conditions that affect the nervous system, such as cerebral palsy
- hiatal hernia
- previous surgery to correct esophageal atresia
Pathophysiology
The primary mechanism of reflux in neonates especially in preterm infants is transient lower esophageal sphincter relaxation (TLESR). TLESR is an abrupt reflex decrease in lower esophageal sphincter (LES) pressure to levels at or below intragastric pressure, unrelated to swallowing. Preterm infants have dozens of episodes of TLESR each day, many of which are associated with some degree of GER. As such, GER is a normal phenomenon in infants, which is exacerbated by a pure liquid diet and age-specific body position. Delayed gastric emptying does not appear to play a contributory role in GER. However, GER is more common immediately after a feeding, likely because of gastric distension. Body position also influences TLESR and GER in infants. Infants placed in the right-side-down lateral position after a feeding have more TLESR episodes and liquid reflux compared with the left-side-down lateral position, despite gastric emptying being enhanced in the right lateral position. Prone position also decreases episodes of GER versus supine position, likely because of more optimal positioning of the LES relative to the distended stomach.
Mechanisms to protect the esophagus and airway from GER appear to be intact even in the preterm infant. These include reflex forward peristalsis of the esophagus in response to distention from refluxate in the lower esophagus with closure of the upper esophageal sphincter to prevent refluxate reaching the pharynx. Despite these mechanisms, if refluxed material does reach the upper esophagus, the upper esophageal sphincter will reflexively open to allow the material into the pharynx, which results in the frequent episodes of “spitting” or emesis observed in infants.
Diagnosis
- Upper gastrointestinal (GI) endoscopy
- Esophageal pH monitoring
- upper GI series
Treatments
Lifestyle changes like
- avoid exposing the infant to passive smoking
- burp the infant more often.
- change the infant’s diet.
- hold the infant upright for 20 or 30 minutes after he or she eats, if practical
- An infant should always be placed on his or her back for sleep
Medicines like proton pump inhibitors (PPIs) or H2 blockers are used in some cases.
Prognosis
Mostly self-limiting, and self-relieving
Complications
Esophagitis
Poor weight gain
Cough
Laryngitis
Pneumonia
Wheezing
Disease & Ayurveda
Sisuchardi
Nidana
Unwholesome diet of mother
Bad quality of breast milk
Purvaaroopa
Not mentioned
Samprapti
Not mentioned
Lakshana
Frequent belching without any reason
Excessively sleepy baby
Excess yawning
Divisions
Not mentioned
Prognosis
Saadhya
Chikithsa
While describing Ayurvedic treatment of babies, Acharya explains that, for any disease developed in a baby who is only breastfed, medicines and treatments are recommended only for mother unless an emergency condition.
Chardi in babies are very common and usually is self-limitng. It gets better by time as the baby starts crawling and walking. Taking solid foods also helps the baby to get rid of frequent vomiting.
So, treatment is needed only when the nourishment is compromised and the child is weak & sick.
Samana
Aamappaachana and agnideepana with medications to the mother
Sodhana
Vamana and virechana for the mother only in needed cases
Commonly used medicines
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Tap the baby’s back and let him release the air ingested while feeding through mouth.
Diet(mother)
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, fresh fruits & vegetables
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme hot & cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Yoga
Regular stretching and mild cardio exercises are advised for otherwise healthy mother. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
PMID: 31861951
A multicenter perspective cross-over study was conducted in formula-fed infants with persisting regurgitation, randomly assigned to receive two weeks of a magnesium-alginate-based formulation followed by two weeks of thickened formula, or vice-versa. Infants, exclusively breast-fed, were followed up for two weeks while receiving magnesium alginate. Symptoms of gastroesophageal reflux (GER) were evaluated through the Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R). Direct cost of treatments was also calculated. Seventy-two infants completed the study. The researchers found a significant reduction of I-GERQ-R scores over time in all groups with no difference between the sequences of administration in formula-fed infants and between exclusively breast-fed and formula-fed infants receiving magnesium alginate. The mean cost savings per infant was lesser in formula-fed infants treated with magnesium alginate compared to thickened formula . Conclusions were that the magnesium-alginate formulation reduces GER symptoms both in formula-fed and breast-fed infants. In formula-fed infants, clinical efficacy is similar to thickened formulas with a slightly lower cost of treatment.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Please consult Dr. Rajesh Nair here-
https://www.ayurvedaforall.com/online-consultation.html
https://www.ayurvedaforall.co.uk/online-consultation/
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com
Whatsapp – +91 9446918019, +91 8075810816
URLs: https://www.ayurvedaforall.com/
https://www.ayurvedaforall.co.uk/
To give you a quick idea about Ayurvedaforall, we are a group of ayurvedic practitioners committed to propagating Ayurveda in its best tradition around the world. Our online store sells authentic ayurvedic formulations backed by professional advice. Now into the seventeenth year of operation, the site has helped us build a dedicated clientele which regularly uses our products and services as well as refers others to us. Needless to say, this has been achieved through our adherence to the highest standards of customer service and professional ethics.
Dive into authentic Ayurvedic products from top manufacturers like Kottakkal at