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My son will is almost five months old. Shortly after he was born, he was diagnosed with acid reflux. He would spit up after every feeding. The doctor put him on Zantac. We tried this for a week, but his condition stayed the same. Next, the pediatrician tried Maalox. This worked like a miracle, and after two weeks on this medication he was a lot better. Now he rarely spits up after meals, but he spits up a lot when he wakes up from naps. Is this something to be concerned about?
When the stomach contracts as part of the normal digestive process, the food is supposed to move in one direction, namely toward the small intestine. The food usually does not come back up the esophagus (the food tube connecting the throat to the stomach) because there is a sphincter that stays closed while the stomach contracts. However, in those with reflux, this sphincter does not work appropriately, so when the stomach contracts, some of the food goes the correct way. But some comes up the espohagus which results in spitting up.
Reflux is very common in infants. And as long as it does not cause problems with weight gain, it is typically considered a nuisance, not a medical concern. Therefore, medications or significant changes in diet are generally not necessary. There are some medications that are sometimes used in reflux, such as Zantac. However, these are usually used only when the reflux seems to be causing discomfort in the child. But when these are used, they most often do not decrease the amount of reflux. Why is this? Medications such as Zantac decrease stomach acid, so when the reflux occurs, it is not as painful. But, in children, decreasing the stomach acid dosn't suddenly make the sphincter work any better, it just makes the stomach acid less irritating.
There is a formula that tries to address issues surrounding reflux called Enfamil AR. It has rice starch that curdles when it hits the low pH of the stomach making it less likely for reflux to occur. However, if your child is on Zantac, then the stomach pH isn't low, so the Enfamil AR won't work.
Ultimately, it is important to realize that reflux is quite common in babies. It most often causing no significant problems other that having to do a lot of laundry. Most babies outgrow this by one year of age. However, every child is different, so it is important do discuss any treatment or non-treatment with your pediatrician.
