Does Your Baby Have GERD?

Before you can understand GERD you need to comprehend what GER is.

GER is describes a continuous every day normal function. Very simply, gastro esophageal reflux (GER) describes the physiologic condition in which stomach contents come back up from the stomach into the esophagus. It is a physiologic process, which means it is normal. In fact all babies have reflux and so do you. It is normal for the stomach to occasionally push its contents up into the esophagus briefly every now and then. It is how often that the stomach does this that makes it a painful thing.

In a healthy baby GER doesn't cause problems. The acid that makes up the refluxed material can irritate the esophagus and upper airway so much that symptoms develop.

When symptoms interfere with a baby's day-to- day activity reflux is referred to s gastroesoophageal reflux disease (GERD). Doctors may refer to it as pathologic reflux.

The difference between GER and GERD is key. It helps us discriminate between a normal function and an abnormal one. Babies with GER spit up but don't suffer any consequences. This is your average happy, healthy growing baby with wet burps.

On the other hand babies with GERD typically face problems relating to feeding, growth or breathing as a consequence of their reflux. These are typically identified, as sick babies ho need medical attention. So while all babies have some degree of GER fewer suffer from GERD.

Everyone including you and your baby experiences reflux during the day. However as an adult you do not need a burping cloth.

Babies' reflux is due to elements of infant physiology and anatomy, which may lead some credence to Dr. Harvey Karp's theory that there is a 'fourth trimester' that a baby experiences outside the womb. (Karp is a very famous contemporary pediatrician whose advice is dutifully followed by many parents.)

The theory is that usually a faulty stomach valve causes GERD. It is faulty in a baby because it has yet to develop.

This valve in question is at the bottom of the esophagus. It is a ring of muscles called the lower esophageal sphincter (LES) that helps keep stomach contents where they belong.

In babies the LES does not stay squeezed closed. When this happens stomach contents are allowed to flow back into the esophagus. By the time a baby is six weeks old these muscles grow stronger and less regurgitation is likely.

The fact that reflux can go on more than one or two months o face tells us that reflux is due to more than just a LES issue.

On of the major factors contributing to reflux in infants is the delayed emptying of the stomach. Under normal circumstance a liquid meal should be gone from a baby's stomaching approximately a half an hour to an hour. During the first months of a baby's life the stomach can be inefficient at emptying and milk has a tendency to sit in the stomach longer than it should. This is because the baby just has slower intestinal motility and there is nothing anyone can really do about it except cope with it and be tolerant until the baby's digestive system is more mature.

What is Colic Really?

Colic is a fifty-year-old term for an irritable baby and there is not even a real scientific way of diagnosing it. Some doctors will diagnose it if the baby will not be put down to go to sleep, which is ludicrous if you consider the entire medical, psychological, and other factors that could be causing a baby to be sleepless.

Other doctors will employ what is called the White Noise Rule. The diagnosis is confirmed if the baby settles down after listening to some kind of loud droning sound such as a vacuum cleaner or hair dryer. The diagnosis in effect comes after the cure has been established.

It is only lately that both the medical community and the general public understand colic a little better.

Recently, with the creation of pediatric gastroenterology as a specialty in children's medicine, the causes and cures for colic have been better understood. Believe it or not this is a specialty of gastroenterology that only became recognized by the American Board of Medical Specialties in 1988. Since then smaller endoscopes that can help diagnose what goes on inside a colicky baby's belly has been developed and so have pediatric versions of common medicines to treat some of the physical symptoms of colic including nausea, gas and diarrhea.

In the last decade or so many cases of colic are thought to be caused by acid reflex. This is the backflow of stomach acid into he esophagus. This is the muscular tube that carries food and drink to the stomach. Using fiber optic endoscopes doctors have been able to detect that acid reflux does exist in colicky babies.

Advancements in infant nutrition have also led to the development of hypoallergenic formulas that became available for common use in the early 1990s. This has revolutionized the care and feeding of the infant with severe allergic disease. Endoscopic technology has also now allowed doctors to 'see' an intestinal allergy on a television screen.

When breastfeeding causes colic, manufacturers are learning to make a formula that benefits babies who can't breast feed. Formulas that were once nothing more than a vehicle for protein, fat and carbohydrate now sometimes contain long-chain fatty acids that have been show to improve visual and cognitive function in infancy and beyond. In essence they become super formulas that are more than a substitute for mother's milk.

Pediatric over-the-counter drugs have also evolved for use in children. There are now safe, effective antacids for children and all kinds of gas drops and gripe waters on the market that are safe, effective and can provide your child with great relief.

The bottom line is that you need to realize that a cranky colicky baby is just that. There is no real definition for colic and even the medical community is not sure what it is. All you can do is try every avenue that you can to try and solve the problem.