All newborn babies can experience some degree of reflux, and the subsequent symptoms are fussiness, crying and difficulty sleeping. Find out how a baby with GERD symptoms can often be treated by changing their sleeping position with help from a gastroenterologist in this free video on acid reflux and GERD symptoms.

Expert: Miguel J. Rodriguez
Bio: Dr. Miguel J. Rodriguez is board-certified by the American Board of Internal Medicine and Gastroenterology.

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Repeated episodes of acid reflux or heartburn in toddlers and children should trigger an appointment with your pediatrician.

If your pediatrician finds no underlying reasons for heartburn in your child, you may want to take steps to prevent it. Take note that prevention may differ from one child to the next. So, what works for one may not work for another. Try these 7 steps and see which works best for your child.

1. Be sure the child’s clothing is not tight at the waist during and immediately after meals. Tight clothing can put pressure on the stomach, which in turn pressures the LES and produces heartburn.

2. Give the child something quiet to do immediately after meals. Returning to active play can pressure the stomach before it has digested the food and prompt heartburn. Children should be instructed not to bend at the waist for 15 to 30 minutes after eating.

3. Heartburn in toddlers and children can often be a matter of excess weight, especially at the waist. Ask your pediatrician what your child’s weight should be. If he or she is overweight, work with the doctor to get them to a healthy weight to prevent heartburn.

4. Serve smaller meals. Overeating will result in a stomach that is too full to do its work properly. The churning motion a too-full stomach can, like the churning motion of an overfilled blender, cause the “lid” to pop open. When that lid is the sphincter ring of muscle, heartburn can result.

5. Serve small snacks between meals. This will allow the child to get enough nourishment, and not be as eager to overeat at meals.

6. Withhold junk food that is high in fat and sugar. Heartburn in toddlers and children can be caused by a diet that is unbalanced, and lacking in nutritious food.

7. Eliminate beverages that contain carbon dioxide (bubbles). Too much gas in the stomach can caused the sphincter to open at the wrong time. Heartburn in toddlers and children is often prevented quickly by disallowing soda pop with the meal.

If you try all of these without gaining relief, you may want to begin a food diary, writing down everything your child eats each day. When heartburn occurs, log it in immediately to see if a specific food has been eaten before each episode. When you visit the pediatrician, show him or her the food diary.

Heartburn in toddlers and children can occur at night. The child may awaken crying and complaining of pain in the upper abdomen or lower chest. Perhaps the heartburn occurs in the evening before going to bed. This type of heartburn can often be avoided by not allowing the child to eat right before going to bed.

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“These findings demonstrate that we really need to start looking for dental erosions in pediatric patients with chronic acid reflux and integrate proper dental care into their treatment regimens,” said Dr Melvin Heyman, chief of pediatric gastroenterology, hepatology and nutrition at UCSF Children’s Hospital and the study’s senior author.

Dental erosion causes the enamel to weaken, resulting in tooth sensitivity and increase the risk for tooth decay.

The study compared the dental health of patients aged 9 to 17 with symptoms consistent with acid reflux disease to those with no symptoms. The children with acid reflux were almost six times more likely to have substantial evidence of teeth erosion than those without.

Currently, the study shows positive correlations between acid reflux and dental erosion. However, the researchers are not yet certain what causes children with reflux to develop the erosion, and they say this will be a point of future study.

Obviously, detecting chronic acid reflux in children is the key to prevent the long term damage on the teeth associated with dental erosion and GERD. Do not hesitate to bring your child to see your doctor if you suspect he/she has the symptoms consistent with acid reflux.

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Lately, researchers at Standford University looked at all the research publication from 1975 to 2004 to find out more about how lifestyle modifications can help heartburn acid reflux patients. Their research includes the findings on the impact of coffee, chocolate, alcohol, obesity, and bed elevation on acid reflux symptoms. In fact, they found that the only lifestyle changes that made a difference for GERD symptoms were weight loss and head of bed elevation. There is no evidence to prove that the acid reflux symptoms got worse after the cessation of tobacco, alcohol or coffee.

In 1999, a study was carried out to look specifically at the effect of coffee on GERD patients. A small sample of 15 people with one group of eight persons having acid reflux disease and one group of seven persons without acid reflux disease. Each group was been alternated between drinking warm water and coffee and then measure the acid reflux of each person in the group. As the result, the researches found that drinking coffee had no significant effect on acid reflux in any individual of the two groups.

Interestingly, many individuals reported coffee makes their heartburn acid reflux symptoms worse despite the research studies show that coffee had no impact on those who were suffering from acid reflux disease.I guess that the point the anecdotal information and the research information support is that individuals vary in their reaction to certain foods and beverages.

Conclusively, if you have heartburn acid reflux disease, your reaction to coffee or any other beverage will be very individualized. Now, you know that if someone tells you that coffee will definitely make feel worse, you know that is not necessarily true.

However, the research to date on the topic is still early stage and so when it comes to coffee and acid reflux you need to determine what works best for you.

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GERD is a common disease in which fluid from the stomach backs up into the esophagus, typically causing chronic heartburn and other symptoms, which can lead to erosion of the esophagus. In addition to drugs that reduce the secretion of this acidic fluid, GERD may be treated with a type of surgery called fundoplication that tightens the junction between the esophagus and stomach.

Previous studies in adults have suggested that as many as four out of five asthmatics experience the chronic cough and hoarseness of acid reflux. While the connections between asthma and GERD remain unclear, researchers have noticed that antireflux medications can sometimes help asthma symptoms.

“About two thirds of patients with asthma have underlying reflux and GERD has been implicated in provoking asthma,” Dr. Vikram Khoshoo, a pediatric gastroenterologist from West Jefferson Medical Center, New Orleans, who was involved in the study, told Reuters Health.

To investigate this relationship further, he and his colleagues had 62 children, between 6 and 11 years old, with asthma undergo esophageal acid testing. Forty-four children with abnormal results suggestive of GERD received anti-reflux therapy (either medical or surgical), while the remaining 18 patients served as the comparison group and continued their asthma regimen.

After 2 years, children receiving anti-reflux therapy experienced less than one asthma flare-up per year, compared with almost three flare-ups per year among other children.

Breathing tests confirmed improved lung function with anti-reflux therapy.

“We found that when you take children with persistent asthma and GERD and treat them with anti-reflux medication, their asthma outcomes are better, they require significantly less asthma medication over the years, and they have fewer exacerbations of asthma,” Khoshoo told Reuters Health.

GERD is being missed in a lot of children who have persistent asthma, Khoshoo noted. “I think the message has to be — if a child has persistent asthma without any risk factors or he has persistent asthma and despite adequate medication and compliance is not getting better, then it’s possible that reflux may be playing a role.”

When reflux is treated, there should be an improvement in symptoms outcome, a reduction in the need for asthma medications, and an improvement in lung function, he added.

Recently, in Wall Street Journal, there is article -Baby Crying? Doctors Say It May Be Acid-Reflux Disease shares about a parent’s experience on discovering that her 1 month old baby was actually suffering from mild GERD – gastroesophageal reflux disease when a pediatric gastroenterologist diagnosed it.

Most babies have reflux — spitting up some liquid, since the valve separating the stomach from the esophagus isn’t fully closed. It usually doesn’t hurt. Experts like to say these “happy spitters” are a laundry problem, not a medical problem, and no treatment is needed. Most babies outgrow this simple gastroesophageal reflux (or GER) by the time they’re about 7 months old.

GER becomes more-serious GERD if the infant won’t eat and stops gaining weight, vomits blood and is extremely irritable. He may be highly sensitive to stomach acid — “just like some adults get heartburn and call 911,” says Beth Anderson, founder of the Pediatric/Adolescent Gastroesophageal Reflux Association (Pager), an information group for parents.

GERD babies may also choke or aspirate liquid. Acid-reducing drugs — which run the gamut from over-the-counter antacids to H2 acid suppressors to PPIs — won’t stop the reflux but can cut the acidity, and thus the irritability, if acid is causing the problem.

Most experts think colic is a separate issue, though it’s still vaguely defined as at least three hours of crying at least three days a week for at least three weeks. Doctors theorize that it may be because of a milk allergy, gas or food not moving smoothly through immature intestines. Some 20% of babies get colic, and it’s generally gone in three months — but those can be miserable.

The problem comes in when colic and reflux can occur together. “Those babies are sometimes put on acid-reducing medications, but they don’t get better,” says Jeffrey S. Hyams, a pediatric gastroenterologist at Connecticut Children’s Medical Center in Hartford, and Olivia Manganello’s doctor. “There’s no medicine for colic except time and Mother Nature.”

Doctors can check for abnormal acid by putting a thin tube down a baby’s nose, and rule out anatomical problems with a barium X-ray. But many simply put babies on acid-reducing drugs first to see if they improve. Some critics say that leads to overtreatment.

Are we putting the babies to harm by giving drugs for GERD if it is just colic? None are specifically approved for infants. For older children, the side effects are generally mild, like nausea and diarrhea; PPIs have been linked with a risk of bone fractures in adults. But few long-term studies have been done.

Even you leave it untreated, some babies outgrow GERD, but doctors worry if it prevents an infant from eating. “Babies need to gain weight,” says Dr. Hyams. “If they don’t, there’s something wrong.”

Thus, this often leaves the parents in the dilemna. If you are in the situation, please consult your child’s doctor. At the same time, please read up more information about babies with acid reflux. You may want to get this book:

The Reflux Book: A Parent’s Guide to Gastroesophageal Reflux

These days, many children are suffering from acid reflux. Actually it is quite common for children to have a degree of GERD than not. This is usually so because of the highly active lifestyle or the diet that the kids are having now.

So, how do you know if your child has GERD?

If you notice that your child is vomiting a lot or their vomit is a yellow-ish or green-ish color, there is a likelihood that he may be suffering from it. If he has difficulty in breathing after coughing or vomiting, that is also a sign of GERD.

Generally, the acidic liquid will cause hoarseness in the throat and persistent coughing. Furthermore, if your child is refusing to eat their food, or they suffer obvious signs of difficulty in chewing or swallowing, you may want to investigate. However, most children can grow out of any sort of acute GERD. Any form of treatments like surgery or any other serious remedy to the problem is only necessary in the most severe cases.

Most of the time, the doctors blame the child’s underdeveloped digestive system for these problems.

One of the ways to inhibit this issue in your infant is to keep your baby upright for 30 minutes after they have been fed. This advice is similar for adults, in which case they recommend that you not eat before going to bed and to arch your pillow up thirty degrees while sleeping in order to make any sort of rise in secretion difficult. The main issue here is to block the rise in stomach acid from getting to the top of your esophagus, and the back of your throat. You need to be aware of this immediately after you eat, as that is when your stomach is producing the acids to help digest your food.

In most cases, however, the acid build up will return back to the stomach and will not cause any sort of damage to the voice or result in any coughing fits. Your child will most likely simply outgrow acid reflux and will resume a healthy digestive order as they grow older.

With that said, if you find that these symptoms persist, you should most certainly consult a physician to be on the safe side as well as follow a few simple rules including:

- Do not feed your child 2-3 hours before bedtime
- Remove any sort of acidic or caffeinated drinks/food from their diet
- Exercise regularly
- Eat 5 or more small meals throughout the day, rather than three large ones.

The main causes with children’s acid reflux are often attributed to too muchof acidic or digestive secretions in the stomach. So, anything that you can do to reduce these in your child, the more likely it will be that the symptoms will ease.

It is always best to visit your child’s doctor whenever the symptoms persist. A medical checkup will help your child to get well faster.

Currently, the Duke researchers are doing a national study on the possible link between asthma and acid reflux.

Tameka Bullock said she can’t remember when her 7-year-old son, Chris, hasn’t had problems breathing.

“You could just tell that he wasn’t getting enough air, just as a small baby,” she said.

According to Chris, his problems often pop up at play time and he would start coughing and has to stop playing.

Now, he is part of a national trial at Duke because he has had another problem: acid reflux or GERD – when acid leaves the stomach and irritates the lining of the esophagus. It can even causing vomiting.

The reflux-and-asthma combination is common enough that doctors want to know if there’s a connection.

Dr. Larry Williams, a Duke pediatrician said that doctors are interested to know whether GERD as a trigger for asthma and, whether they need to treat GERD as well.

Presently at the trial, some kids get a study drug to neutralize stomach acid while others get a placebo. It is a requirement that they keep daily diaries and other homework to track their asthma symptoms.

The aim of the research is find out a better way to control of asthma symptoms for kids. Chris’ parents say they’re for anything that might help him and others with asthma lead more normal and active lives.

Duke is still looking for young study participants for the trial. Candidates must be 5 to 17 years old, taking daily asthma medications and exhibit asthma symptoms several times a week. Call Nurse Coordinator Ginny Dudek at 919-684-0191 or e-mail DukeAsthma@duke.edu.