How can my child's acid reflux be treated?

In this article below, distinguished consultant paediatrician, Dr Bushra Al-Rubeyi, outlines the most common symptoms associated with acid reflux in children, and how they can be treated effectively.

What are the symptoms of acid reflux in children?

There are many symptoms of acid reflux in babies and children. Children who can express themselves (over the age of five) will say that they are experiencing the following:

• heartburn and vomiting
• foul taste in their mouth (an acid/bitter taste)
• tooth decay
• bad breath
• chest pain
• voice changes or voice hoarseness
• feeling nauseous
• feeling bloated
• hiccups
• persistent cough

Children who are not yet of the age to be able to express themselves also suffer from acid reflux-related symptoms. Parents will tell us that their baby is vomiting after most feeds. Common symptoms in these cases include:

• the baby is very irritable
• constantly crying
• the baby finds it difficult to settle
• the baby pushes the food away
• wheezing
• persistent blocked nose
• choking
• hiccups
• arching back
• coughing
• frothing

All of the symptoms outlined above are common symptoms of acid reflux in babies. Most babies have more than one of these symptoms. Acid reflux can also be silent, where the babies and children don’t vomit but they have all the other symptoms of acid reflux.

What causes acid reflux in children?

Our digestive system is designed as a one-way system, so there is no going back as such. The only way is down, in other words. When we eat food and swallow it down into the stomach, there are rings on both ends of the stomach.

These rings are made up of tight muscles and act as gates to prevent the food and stomach juices from escaping in the wrong direction. If the ring that connects the stomach and the oesophagus is not closing tightly or if the closure happens at the wrong time, acid reflux occurs.

Is acid reflux common in children?

In babies and infants, it is common. Four out of 10 babies will suffer from acid reflux but only a very small proportion will require medical attention. I am seeing increasing numbers of older children with acid reflux and more so post COVID.

How can my child's acid reflux be treated?

For the majority of older children, I will advise them to prioritise lifestyle changes. For example, they could avoid certain foods such as chocolate, spicy foods, citrus fruits, and peppermint. Some children may also require a course of medications to improve symptoms.

In the majority of infants and babies, symptoms are mild and improve naturally without treatment. The natural history of reflux in babies is that it gets better when the infant starts sitting up and when they start eating solid foods. In babies, feeding little often helps the symptoms and parents should ensure that their babies are positioned upright while feeding, and for a half an hour after finishing their meal.

Thickened feeds could help. Infant gaviscon and other medications (in small doses) are sometimes needed to control the symptoms. This should always be done under medical supervision.

To book a consultation with revered consultant paediatrician Dr Bushra Al-Rubeyi, simply head on over to her Top Doctors profile today.