Gastroesophageal reflux (GER) is a physiological, normal condition in newborn babies. It involves passive coming back of the stomach content up in the esophagus (regurgitation). It affects 40% of the newborn babies and is caused by the underdeveloped lower esophageal sphincter (LES) that closes the connection between the esophagus and the stomach. Due to this, after every feeding of the baby, stomach content returns from the stomach into the esophagus. This may continue up to the age of 6 – 12 months, and sometimes even as far as 18 months. Babies develop and put on weight as expected. They are normally calm after feeding, don’t cry and don’t show symptoms of pain. This condition doesn’t require treatment. In breastfed babies, adjustment is done to the eating habits of the mother. She should best avoid the consumption of spicy, hot, greasy and fried foods, as well as citrus fruits, chocolate, onions, garlic, peppermint sweets, caffeine, fizzy drinks, which lower the LES tone and thus have a beneficial impact on the reflux. Some scientists say that breastfeeding mothers should also avoid dairy products.
In more severe cases of GER, the baby’s doctor may prescribe a medicine, based on magnesium alginate which protects the esophagus mucosa from the harmful effect of the hydrochloric acid, that should be taken after every feeding. Typically, these preparations also contain herbal extracts, which reduces the intensity of the reflux and increases the LES tone. Babies feeding on formula milk need to switch to a special anti-reflux formula. The anti-reflux formulas contain specific ingredients which thicken the milk and thus regurgitations are reduced. Such ingredients are carob gum, starch, etc. Change in the baby’s sleeping position and also its position after feeding is also recommended. Keep it in a more straight position, at a 30⁰ – 45⁰ angle. Which means that it is a good idea to hold your baby into your arms longer after feeding, in a semi-straight position. Also, you may raise the side of the mattress where you place the baby’s head. To do this, place a pillow or a special pad under the mattress. Make sure the pillow is under the mattress (don’t use it as a regular pillow for the baby because this will impose certain risks). It is very important to diagnose GER as a condition unrelated to other conditions causing regurgitation in newborn babies, especially during the first 28 days of its life. Regurgitation may be a symptom of cow’s milk protein allergy, gastroesophageal reflux disease (GERD) and some inborn anomalies of the gastrointestinal tract, such as pyloric stenosis and many more. In cases of GERD, regurgitation causes changes in the esophagus mucosa due to the impact of the hydrochloric acid. In such cases the babies are restless after feeding, they don’t feel cheerful and refuse to eat. In cases of pyloric stenosis, there is an obstruction in the pylorus that causes “projectile vomiting”, as well as noticeable decrease in the weight the child puts one. Typically, symptoms appear around the second week after the birth. If you notice any such symptoms in your child, it is best to consult your doctor so they can properly examine the baby.