Gastroesophageal reflux in infants: what you need to know to manage it properly

Gastroesophageal reflux in infants: what you need to know to manage it properly

Very common in children under one year old, gastroesophageal reflux known as “GERD” often worries parents, but it can be reduced. The High Authority for Health (HAS) yesterday published its new recommendations to optimize the management of these regurgitations, whether they are pathological or not.

Parents of a child under one year old, you may have to deal with your baby’s gastroesophageal reflux disease. This unpleasant rise of part of the gastric contents into the esophagus affects nearly 70% of infants aged 4 months. Fortunately, it often disappears naturally with dietary diversification and the acquisition of walking, when it is a physiological GERD. But another form, pathological GERD, may need drug treatment. How to sort things out? HAS has published a new sheet on this subject for pediatricians but also parents to avoid overmedicalization.

Physiological or pathological GERD, what is the difference?

Thus, as the HAS points out, crying, irritability or sleep problems which often go hand in hand with this disorder do not alone make it possible to identify pathological GERD.

The HAS thus reminds that simple regurgitation is not serious, does not require a test to be diagnosed or drug treatment, as long as the infant’s weight curve is normal and the warning signs that may suggest a other pathology (jet vomiting becoming frequent, bilious vomiting for example) were ruled out. In this case, it is therefore necessary to reassure parents and propose hygienic and dietary measures.

When it is pathological, GERD results in other signs:

  • Traces of blood in regurgitation;
  • Repeated refusal of the bottle;
  • Break in the weight curve;
  • Failure of measures already implemented.

In this case, the action to be taken is taken based on the case observed.

The IPP, only in cases of pathological GERD, and on a case-by-case basis

The HAS reminds us that there are also medications that can be used to reduce acid secretions from the stomach in the event of pathological reflux: these are proton pump inhibitors (PPI). However, there is little scientific data on this class of medications in children under one year old, while their use can also cause undesirable effects in children (such as diarrhea, constipation, nausea, etc.) or gastrointestinal and respiratory infections. The appeal should therefore not be automatic.

The HAS recommends using these medications only when justified and following additional tests (pH-metry or esophagogastroduodenal endoscopy) to confirm the diagnosis of pathological GERD.