Gastric Reflux is a common problem particularly in pre term babies. It can be defined as a transient, inappropriate relaxation of the lower oesophageal sphincter allowing stomach contents to flow back into the oesophagus. This can result in regurgitation or vomiting, which may upset the child by causing pain and discomfort or, in milder cases there may be no apparent distress related to these events.
Recently there was an article in the BMJ which looked at this topic and the rich variety of treatments on offer. This article found that, although there are treatments offered there are no drugs licensed for use in infants and the trials that have been completed have been too small with inadequate controls to be accepted.
Using formulas which thicken on contact with stomach acids , such as Efamil AR and SMA Staydown ( both available on NHS prescription) are only moderately effective in treating reflux in otherwise healthy children.
A study looking at positioning the infant with the head of the crib raised, found that this is not always justifiable, but placing infants on their left side, can reduce reflux. Lying on one side is not a stable position for infants and using pillows to maintain this position is not recommended.
Gaviscon Infant powder was effective in reducing vomiting and regurgitation in episodes at 14 days, but did not reduce the level of vomiting, and another double blind trial found no difference when Gaviscon was used.
In using drug treatments to reduce the level of acid in the stomach may increase the rate of gastroenteritis in children younger than 4 months, and would not be acceptable in pre term infants or low birth weight babies.
Reflux, like colic, is self limiting. It can be difficult for parents to watch an infant in distress and pain without seeking assistance to make the child more comfortable. Unfortunately this article has no positive statement to make on an effective treatment or intervention, for this condition.
Recently there was an article in the BMJ which looked at this topic and the rich variety of treatments on offer. This article found that, although there are treatments offered there are no drugs licensed for use in infants and the trials that have been completed have been too small with inadequate controls to be accepted.
Using formulas which thicken on contact with stomach acids , such as Efamil AR and SMA Staydown ( both available on NHS prescription) are only moderately effective in treating reflux in otherwise healthy children.
A study looking at positioning the infant with the head of the crib raised, found that this is not always justifiable, but placing infants on their left side, can reduce reflux. Lying on one side is not a stable position for infants and using pillows to maintain this position is not recommended.
Gaviscon Infant powder was effective in reducing vomiting and regurgitation in episodes at 14 days, but did not reduce the level of vomiting, and another double blind trial found no difference when Gaviscon was used.
In using drug treatments to reduce the level of acid in the stomach may increase the rate of gastroenteritis in children younger than 4 months, and would not be acceptable in pre term infants or low birth weight babies.
Reflux, like colic, is self limiting. It can be difficult for parents to watch an infant in distress and pain without seeking assistance to make the child more comfortable. Unfortunately this article has no positive statement to make on an effective treatment or intervention, for this condition.
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