Symptoms:

Signs of infant acid reflux may include:

• Spitting up
• Irritability during or after feedings
• Poor feedings

When to see a doctor:

Normal infant acid reflux doesn't interfere with a baby's growth or well-being. Contact your baby's doctor if your baby?

• Isn't gaining weight.
• Spits up forcefully, causing stomach contents to shoot out of his or her mouth.
• Spits up more than a tablespoon or two at a time.
• Spits up green or brown fluid.
• Resists feedings.
• Is irritable after feedings but improves when held upright.
• Has fewer wet diapers than normal or appears lethargic.
• Have other signs of illness, such as fever, diarrhea or difficulty breathing.

Some of these signs may indicate more serious conditions, such as gastro esophageal reflux disease (GERD) or pyloric stenosis. GERD is a severe version of reflux that can cause pain, vomiting and poor weight gain. Pyloric stenosis is a rare condition in which a narrowed valve between the stomach and the small intestine prevents stomach contents from emptying into the small intestine.

     Causes:

Normally, the ring of muscle between the esophagus and the stomach (lower esophageal sphincter) relaxes and opens only when you swallow. Otherwise, it's tightly closed — keeping stomach contents where they belong. Until this muscle matures, stomach contents may occasionally flow up the esophagus and out of your baby's mouth. Sometimes air bubbles in the esophagus may push liquid out of your baby's mouth. In other cases, your baby may simply drink too much, too fast.

     Complications?

Most cases of infant acid reflux clear up on their own without causing problems for the baby. Rarely, infant acid reflux can lead to poor growth or breathing problems. Frequent episodes of infant acid reflux may be more likely to develop gastro esophageal reflux disease during later childhood.

Treatment?

• Most cases of infant acid reflux clear up on their own. Treatment is typically limited to simple changes in feeding technique — such as smaller, more frequent feedings, interrupting feedings to burp or holding your baby upright during feedings. If you're breast-feeding, your baby's doctor may suggest that you avoid cow's milk or certain other foods. If you feed your baby formula, sometimes switching brands helps.
• Babies who have severe infant acid reflux or GERD, more aggressive treatment may be recommended
• Medicationslike H-2 blockers, such as cimetidine (Tagamet) or ranitidine (Zantac), or proton pump inhibitors, such as omeprazole (Prilosec) or lansoprazole (Prevacid).
• Surgery is rarely advised.

How to prevent acid reflux?

• Feed your baby in an upright position. Follow each feeding with 15 to 30 minutes in a sitting position. Try a front pack, backpack or infant seat. Gravity can help stomach contents stay where they belong.
• Try smaller, more frequent feedings.
• Frequent burps during and after each feeding can keep air from building up in your baby's stomach. Sit your baby upright, supporting his or her head with your hand. Avoid burping your baby over your shoulder, which may put pressure on your baby's abdomen.
• Elevate the head end of the baby.