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Spit up: Parents often confused about an occurrence considered normal in most babies

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Posted: Monday, June 16, 2014 10:00 pm

(BPT) - It is an all too familiar scene for many parents: They are enjoying a relaxing moment watching their baby contently nursing or bottle-feeding and then, inexplicably, the infant spits up. And then it happens again, and again.

Parents often worry: Is spitting up like that normal?

Chances are, it is. It is called gastroesophageal reflux, or GER. And while common infant reflux can be worrisome and frustrating for parents, it occurs in more than two-thirds of healthy infants, a result of the normal development of a baby’s digestive system, according to the American Academy of Pediatrics (AAP).

GER occurs when stomach contents backup into the esophagus, the muscular tube that carries food and liquids from the mouth to the stomach. Infants with GER spit up liquid - mostly made of what they just ate, or saliva and stomach acids - which doesn’t cause problems for most babies. Nonetheless, worried parents are talking to their pediatricians about it during 25 percent of all routine 6-month infant visits, according to a report in the journal “Pediatrics.”

A less common, but more serious condition is called gastroesophageal reflux disease, or GERD. The disease causes severe symptoms, such as trouble breathing, refusing to feed or inability to gain sufficient weight, according to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN).

Despite the number of babies with GER, many mothers are not knowledgeable about common infant reflux versus reflux disease.

A recent survey of more than 750 mothers commissioned by Mead Johnson Nutrition found that just one third said they were familiar with GERD and only one quarter said they are familiar with GER. The mothers in the survey, conducted in February, were ages 18 to 54 and were raising at least one child age 1 or younger.

“Given the unfamiliarity with GER and GERD, it is not surprising that many parents are unsure of the best way to manage their infant’s spit-up,” says Dr. Suzanne P. Nelson, Master’s in Public Health, of Children’s Gastroenterology Specialists in Glenview, Ill. “Medications are not always effective in managing reflux, and medical guidelines recommend first trying lifestyle and nutritional changes before turning to medication for managing infants with both GER and GERD.”

Dr. Nelson recommends the following tips to help manage common infant reflux:

* For bottle-fed babies, consider a pre-thickened specialty formula designed to reduce spit-up. Enfamil A.R.(R) is that type of formula.

* Keep your baby upright after feedings

* Be careful not to overfeed your infant

* Take comfort in knowing that most infants outgrow their reflux by 7 months of age and almost all by a year

* Talk to your primary care physician if you have any concerns about your baby

According to Nelson, parents should know that the AAP in April 2013 expressed concern over the over-prescription of drugs to treat the entire spectrum of reflux, whether moderate to severe.

Medications used to treat GERD are among the most widely used drugs in children younger than a year old. Clinical trials have shown that acid-reducing medications are no better than placebo in treating behavioral symptoms frequently diagnosed as GERD, such as excessive crying and regurgitation, according to multiple published medical studies.

Parents should consult their child’s doctor about any nutrition and health concerns to determine which lifestyle management techniques would be most effective in helping to manage common reflux in their infant.

And then they can cuddle with their baby – and relax.

Parents: To share your experience managing your baby’s common reflux, please visit the Enfamil Facebook page.

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