what are the differences between GER and GERD

gerd

On Monday mornings, my house is a flurry of activity.  Everyone is running a little late, and the house is slightly chaotic as everyone is trying to get dressed and grab their lunches before they head out the door.  I’m dressed for work and ready to take my son to daycare, but he’s crying and needs a feeding.  It takes twenty minutes to drive him to daycare without traffic and I can’t let him cry for that long.  So I pull out a bottle and he eagerly latches on, draining the bottle in a few minutes.

I cover my shoulder with a towel because those cute little burp cloths don’t even begin to contain his spit up, and gently burp him.  Then I set him down for a moment to put on my shoes.  He reaches up at me, smiling, and I lovingly scoop him into my arms.  And then it happens: he projectile vomits all over himself and me.  In a panic about being late, I change his outfit and then mine, running my dirty dress under the sink for a moment.  I barely react as I wipe formula and stomach contents off of my cheek and chest; there’s no time for a shower.  At this point, I feel like I’m covered head to toe in spit up anyway.

While it’s common for babies to spit up, it’s important to be aware that your baby may have a bigger issue.  Gastroesophageal reflux (GER) is common in newborns and babies and the most noticeable symptom is spitting up after eating.  This normal spit up is different from gastroesophageal reflux disease (GERD), which is much more serious.

What is GER?

Gastroesophageal reflux occurs when an infant’s lower esophagus hasn’t developed completely (“Acid Reflux”).  After a baby eats, some of his food travels up through the esophagus, causing heartburn.  The acid reflux is, of course, painful for your little one.  Spitting up is not the only sign of GER.  Colic can be a symptom of GER.  Colic is when your baby is in pain and cries for long periods.  He might vomit up all of the contents of his stomach instead of just spitting up.  The pain from his heartburn may make it difficult for him to sleep or he may wake up frequently during the night.  Hiccuping sounds, wet burps, and drooling are other potential symptoms (“Basic Info”).

For most babies, GER stops as they get older.  As soon as my son was able to lift his head, roll over, and eat soft foods, his symptoms disappeared.  Once babies have more muscle control and are no longer eating a completely liquid diet, spitting up and other symptoms of GER normally go away on their own.

Of course you don’t want to wait a year or more for your baby’s symptoms to clear up naturally.  There are several things you can do to treat your little one’s acid reflux as it occurs.

What to Do

The first step is to talk to your baby’s pediatrician.  They may recommend medication depending on the severity of the symptoms.  If you want to give your baby over the counter medication, talk with the doctor first.  There are many products available from trusted brands, such as Gerber.  I used colic drops for my son and it worked wonders for his GER.

Another helpful tip is to position your baby upright so less of his stomach contents can travel up the esophagus.  You may want to wait a few moments after feeding before burping, especially if he is prone to throwing up after meals.  It is also a good idea to sit him at least partially upright for at least a half hour after feeding.

A sleep wedge under the crib mattress can be helpful as well.  Laying down on a flat surface will only make your baby’s heartburn symptoms worse.  Make sure to follow the directions for installing the sleep wedge so that your baby doesn’t have an increased chance of SIDS.  While the American Academy of Pediatrics advises laying a baby flat on his back to sleep, if he suffers from GER he will probably not be able to sleep well in this position.  For the first few months, my son slept in his rocker so that he was partially upright.  This was the only way I could get him to sleep for more than an hour without waking up in pain.

What is GERD?

When gastroesophageal reflux becomes a disease (the D in GERD), there can be severe consequences for your baby’s health.  Research supports that GERD may be inherited, so if other babies in the family have suffered from acid reflux, that may be the reason why your baby also has the condition (“Basic Info”).

One consequence of GERD is esophagitis.  Esophagitis occurs when the esophagus swells from acid reflux which can lead to bleeding or scar tissue.  Another possible effect of GERD is aspiration, when the contents of the baby’s stomach enter the lungs (“Basic Info”).

One of the most frightening consequences of GERD is malnutrition.  Babies are expected to gain around 5-7 ounces per week for the first few months of life and 3-5 ounces from 6 months to a year old (Hoecker).  If a baby has GERD, the majority of his food may be vomited or spit up, which will not allow him to digest the nutrients he needs to reach growth milestones.  See your baby’s pediatrician right away if you suspect that his symptoms are not normal acid reflux.

What to Do

If your baby’s symptoms are particularly bad, his pediatrician will do several tests for GERD.  Normally the first step is the Barium Swallow X-ray.  Your baby will drink a chalky liquid and have an x-ray.  This test is used to make sure that your baby really does have GERD and the symptoms aren’t due to other issues.   An Endoscopy is another way the doctor can examine your baby’s esophagus and stomach (“Basic Info”).  The 24 hour pH-Probe Study monitors your baby’s acid levels by inserting a small tube in the esophagus.  This test also shows when during the day the reflux occurs most often.

Any time your baby is crying or in pain it is frightening, especially for a new parent.  Monitor your baby’s symptoms closely.  Even if you expect that your baby only has occasional gastroesophageal reflux, it is still a good idea to see his pediatrician.  Any relief that you can bring your infant in his first months of life will make him a happier baby, and you a happier parent.

References

“Acid Reflux (GER & GERD) in Infants.” National Institute of Diabetes and Digestive and

 Kidney Diseases, www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-infants.  Accessed 24 Oct 2017.

Hoecker, Jay L. “How much should I expect my baby to grow in the first year?” Mayo Clinic,

www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/infant-growth/faq-20058037.  Accessed 24 Oct 2017.

“Basic Info.” Pediatric Adolescent Gastroesophageal Reflux Association,www.reflux.org/

reflux/webdoc01.nsf/vwWebPage)/AboutGERD.htm?Open Document. Accessed 23 Oct 2017

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