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So now that we got through the tough stuff, most people want to know: “How can I treat this?” It’s really hard when you’re a parent to see your kid suffering and to think, there really isn’t anything I can do to help. And that’s one of the frustrating things, and it leads to a lot of efforts that can sometimes be a little counterproductive. While there aren’t great medications for this, there are some lifestyle changes you can do that helps food stay down easier. For instance, if you keep your baby in an upright position for about 20 to 30 minutes after they eat or allow them monitored tummy time — and monitoring is really important for small kids, so don’t just leave them on their stomach, but you can watch them on their stomach — this can help physiology, the anatomy and gravity, keep fluid in their stomachs and so they don’t reflux as much.
You can try to burp them more often or in the middle of feed. So you interrupt feeds and do some burping. That might get smaller volumes or help gas get out. So it doesn’t push up fluid. And you can also try to do smaller, more frequent feedings. If you are a smoker, you should avoid exposing your child to secondhand smoke. That does worsen reflux. Generally, the use of medications is not going to help. Medications that we use for reflux in adults are targeted about acid suppression. So they make you make less stomach acid. But acid isn’t what’s causing the problem in babies. What’s causing the problem is that lower esophageal sphincter is opening up. And the medications we use for acid don’t change that. They will not change the amount of volume that’s going up in reflux. We have plenty of studies looking at this. Using them is also a little bit challenging because they can cause issues with the microbiota as well as causing issues with bone density. So we do know that they increase the risk of getting gastroenteritis and other infections of the gut. In rare cases, when children do have neurologic disorders or other illnesses that do increase stomach acid or vulnerability to things like that, we will use those medications. But again, it will not change the reflux itself. It just protects them from some of the acid, and in 99% of children, the acid is not going to be a problem.
