gastroesophageal%20reflux%20disease%20in%20children
GASTROESOPHAGEAL REFLUX DISEASE IN CHILDREN

Gastroesophageal reflux is categorized as a disease [gastroesophageal reflux disease (GERD)] when reflux is associated with warning signs &/or complications, & requires further evaluation.

It is more common in formula-fed infants than in purely breastfed infants.

There is increased incidence in infants at 4 months of age.

Patient Education

Patient/Parent/Guardian Education

Positional Modifications

  • Infants should be kept in an upright position during feeding
  • Infants & children should be fully awake when ingesting food
  • Semi-supine positioning for at least 2 hours after food ingestion may help reduce reflux-related respiratory events
  • Supine positioning during sleep is recommended

Obesity

  • Weight loss should be considered in older obese children
  • Studies have shown improvement in pH profiles in children who lost weight

Smoking & Alcohol

  • Smoking cessation & avoidance of alcohol intake is strongly encouraged adolescents
  • Exposure to secondhand smoke also increases irritability in infants & should be avoided

Lifestyle Modification

Dietary changes

  • May consider switching to milk formula that contains extensively hydrolyzed protein or amino acid-based formula instead of regular formulas
  • Maternal diet modification is encouraged for mothers of breastfeeding infants
    • Avoidance of egg & milk intake may be considered  
  • Thickeners (thickening agent, rice cereals) may be considered in healthy formula-fed infants but should be used with caution especially in preterm infants at increased risk for necrotizing enterocolitis
  • May try small, frequent feedings instead of one big meal while ensuring appropriate total daily amount of nutrition
  • Eating before bedtime should be avoided
  • Food that may trigger symptoms in adolescents (eg caffeine, carbonated drinks, chocolate, mint-containing food, spicy food) should be avoided
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
17 Apr 2019
A family history of testicular cancer (TC), carcinoma, mesothelioma, sarcoma, malignant melanoma and malignant neuroepithelial tumours appears to increase the risk of paediatric and young adults’ TC, suggests a recent study.
19 Jul 2016
Acute gastroenteritis (AGE) remains a significant contributor to paediatric disease burden across the world in the 21st century. Rehydration remains the mainstay of therapy, while pharmacotherapy may have adjunctive benefits. We seek to review the evolution in management strategies of paediatric AGE, in particular the child with viral AGE.
Joyce Lam Ching Mei, 28 Mar 2019
April 17 marks World Haemophilia Day, and this year’s theme is  “Reaching Out – The First Step to Care”. Adjunct Assoc Prof Joyce Lam Ching Mei, head of the Haematology Laboratory and Blood Bank and senior consultant from the Paediatric Haematology/Oncology Service at KK Women’s and Children’s Hospital, Singapore, speaks to Elaine Soliven on the importance of recognizing and managing bleeding disorders in primary care.
Stephen Padilla, 28 Feb 2018
The 2-year preventive oral health programme in Singapore has succeeded in lowering the presence of severe early childhood caries (SECC) among infants and toddlers, driven primarily by the implementation of targeted behaviour modifications, such as reducing the consumption of sweetened milk and increased use of fluoridated toothpaste, reports a study.