While reflux is often synonymous with spit-up, sometimes preemie reflux only comes part way up the esophagus.
This can cause the baby to cough or gag during or after feedings.
Signs of acid reflux in preemies include irritability, refusing to eat, arching their back, and grimacing.
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Feeding difficulties from reflux in preemies can result in slow weight gain and failure to thrive.
Most babies grow out of reflux, though some feeding modifications or treatment may be needed in the meantime.
This article discusses why reflux affects preemies, its common symptoms, and potential complications.
It also goes over the diagnostic process and different treatments that may help.
What Causes Preemie Reflux?
This circular ring of muscle is located at the end of the esophagus.
These can be, but aren’t always, visible as spit-up or vomiting.
The transient relaxation of the LES is actually a normal phenomenon.
Research shows that premature babies with GER have longer hospital stays compared to premature babies without the condition.
Some of these complications may contribute to this.
Experts once thought that GER could trigger apnea and associated bradycardia (low heart rate) in premature infants.
However, the scientific evidence supporting this link is scant.
In fact, studies have found no temporal connection between GER andapnea/bradycardia.
For instance, researchers in one study performed 12-hour overnight studies in 71 preterm infants.
The GER/BPD connection has not been fully teased out.
More studies are needed to determine if there is a causal relationship.
Possibilities include cow’s milk protein allergy, constipation, infection, and neurological disorders.
If it words, GER is likely at play.
Less commonly, diagnostic testsesophageal pH and multiple intraluminal impedance monitoringare used to diagnose reflux in preterm babies.
These tests can be technically difficult to perform, and the results can be challenging to interpret.
At the tip of the catheter is a sensor that can measure the pH of the stomach contents.
This information is recorded over a 24-hour period on a monitor that is connected to the catheter.
Many options to help with this exist.
While medication may be recommended, it is typically only suggested after trying other non-medication interventions first.
Speak with your insurer, if applicable.
Feeding Adjustments
Research suggests that giving smaller-volume feedings more frequently may be helpful.
Sometimes, parents are advised to use thickening agents such as rice cereal added to milk.
Thicker liquids have a harder time getting up and out of the stomach.
Reflux Medications
Research has found that acid-suppressing medications do not reduce symptoms of GER.
As such, the questionable efficacy and safety of these acid-suppressing medications limit their use.
Reflux is still happening, but it’s just not as damaging to the esophagus.
These complications may include the following:
Fundoplication can be performed in very small and young babies.
Surgery on baby is not something that healthcare providers are quick to recommend.
While working with your pediatrician to address this problem, hey be sure to take care of yourself.
Most babies outgrow reflux, but speak to your healthcare provider if you suspect it.
Simple changesor in some cases, medical interventioncan help.
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