Il gastroesophageal reflux, accompanied or not by regurgitation, is a completely physiological phenomenon in infants, which does not require any treatment. To clarify the subject (and avoid giving children medicines when they are not needed!) We asked some questions to Professor Maurizio de Martino, director of the Department of Sciences for Women's and Child Health of the University of the city - Hospital Pediatric Anna Meyer.
- Gastroesophageal reflux and regurgitation: difference
- Why do babies often regurgitate?
- Should gastroesophageal reflux be considered a disease?
- What to do then if the child has reflux with frequent regurgitation?
- Some practical advice to prevent regurgitation
- Can gastroesophageal reflux become a disease?
- What complications can reflux disease give?
Gastroesophageal reflux and regurgitation: difference
Gastroesophageal reflux is the passage of gastric contents into the esophagus; the regurgitation is the same phenomenon, the difference is that the reflux is not seen, while we speak of regurgitation if with the reflux some of the gastric contents also comes out of the mouth.
Various factors are involved in favoring regurgitation in newborns: first of all theirs supply, which is mainly (or exclusively) liquid, and then the fact that they are almost always in a lying position; in newborns there is also a certain immaturity of the cardia, the valve that connects the stomach to the esophagus and which has the task of preventing the ascent of food from the stomach.
It's time to debunk this 'urban legend': reflux is not a disease, but a normal physiological process that occurs practically in all children and adults, especially after meals, without causing any disturbance. There are so many very healthy children, who just because they have reflux are treated with pump inhibitors and other antacids, with all the costs, hassles and possible side effects that follow: nature has put an acid pH in the stomach to defend the 'body; eliminating this useful and beneficial acidity for no reason can only be harmful
Precisely because it is not a disease, reflux does not need to be treated in any way. At most, if the baby is nursing formula milk, the pediatrician may recommend thickened milk. If, on the other hand, he is breastfed, absolutely nothing must be done, but calmly continue with breastfeeding. For the rest, you just have to wait: as the child grows, begins to take solid food and is more and more often in an upright or sitting position, the phenomenon becomes less and less evident and the regurgitation disappears by itself.
If your baby is regurgitating frequently, you can try to keep him in for some time upright position, at least until he burps; another trick may be to take a break from time to time during the feed. And of course arm yourself with patience and ... bibs!
Only in extremely rare cases, which can really be counted on the fingers of one hand. According to the recent joint guidelines of the American and European pediatric gastroenterology societies, we cannot speak of gastroesophageal reflux disease even in children with recurrent vomiting (vomiting, not regurgitation!) And poor growth. Nor can we think of reflux if the child is particularly irritable or has inexplicable crying. In these cases it will be the pediatrician, through the stories of the parents and a careful visit, to evaluate whether it is necessary to deepen the investigations to exclude other causes or if, possibly, to refer the child to a pediatric gastroenterology center.
Only in rare cases, and mostly in children with severe neurological problems, can reflux cause recurrent pneumonia and interstitial lung disease, due to aspiration of gastric contents from the lungs. However, there is no scientific evidence that chronic cough, sinusitis, chronic otitis, redness of the pharynx or deafness are determined by reflux.Read also: The regurgitation of the newborn
- newborn reflux
- regurgitation of the newborn