While many are aware of gastroesophageal reflux disease and its symptoms (heartburn and uncomfortable feeling in the chest) after a big meal as adults, the condition may be prevalent in children as well. Gastroesophageal reflux disease, or GERD, can cause vomiting and fussiness after feeding in infants, and heartburn, stomachache, and chest discomfort in older kids. The condition can be quite common in infants during the first year of life. Most infants, however, outgrow GERD by the time they are one year old. The condition in older children may also improve as they grow, but some cases will require medical treatment.
The burping, heartburn, and spitting up associated with GERD are the result of acidic stomach contents moving backward into the esophagus (called reflux). This can happen because the muscle that connects the esophagus with the stomach (the esophageal sphincter) relaxes at the wrong time or doesn’t properly close. Most infants with the condition are otherwise healthy; however, some infants have predisposing factors, including problems that affect their nerves, brains or muscles. According to the National Digestive Diseases Information Clearinghouse, a child’s immature digestive system is usually to blame. Symptoms may be eased by elevating the head of the baby’s crib, holding the baby upright for 30 minutes after a feeding, changing feeding schedules, or trying solid food with your doctor’s approval.
In older children, the causes of GERD are often the same as those seen in adults. Anything that causes the muscular valve between the stomach and esophagus (the lower esophageal sphincter, or LES) to relax, or anything that increases the pressure below the LES, can cause GERD. Your child may experience heartburn, also known as acid indigestion, which feels like a burning sensation in the chest, neck, and throat. It can last up to 2 hours and tends to be worse after meals. Kids may get relief by avoiding foods and drinks that seem to trigger GERD symptoms such as greasy and fatty foods, garlic, onions, citrus fruits, and spicy foods.
Keeping your child upright at least two hours after eating may minimize the occurrence of GERD, as well as encouraging your child to get regular exercise. Doctors may recommend raising the head of a child’s bed 6 to 8 inches to minimize reflux that occurs at night. Serving several small meals throughout the day rather than three large meals will also keep heartburn at bay.
Certain factors may also contribute to GERD, including obesity, overeating, certain foods, some beverages, and specific medications. There also appears to be an inherited component to GERD, as it is more common in some families than in others.
Available medications for the treatment of GERD include various types of stomach acid reducers and medications to increase the strength of the lower esophageal muscle. These treatments will need to be directed by your pediatrician, family physician, or pediatric gastroenterologist.