Understanding acid reflux in children: A parent’s guide

Written by: Dr Abraham Neduvamkunnil
Edited by: Aoife Maguire

Acid reflux is a common digestive disorder that affects people of all ages, including children. While occasional reflux is normal, persistent symptoms can be a cause for concern. Distinguished consultant paediatrician Dr Abraham Neduvamkunnil explores the causes, diagnosis and complications linked to the disease.




What is acid reflux in children?


Acid reflux, also known as gastroesophageal reflux (GER), occurs when stomach acid flows back into the oesophagus, causing irritation and discomfort. In children, the lower oesophageal sphincter (LES), a muscle separating the oesophagus from the stomach, may not be fully developed, leading to the regurgitation of stomach contents. This can result in various symptoms and, if left untreated, may lead to complications.


What causes acid reflux in children?


Several factors can contribute to acid reflux in children. These may include:


Immature LES: An underdeveloped LES in infants and young children can contribute to acid reflux.


Hiatal hernia: In some cases, a hiatal hernia, where a portion of the stomach protrudes into the chest cavity, can contribute to reflux symptoms.


Dietary factors: Certain foods and drinks, such as citrus fruits, spicy foods, and carbonated beverages, can trigger acid reflux.


Obesity: Excess weight can put pressure on the abdomen, leading to increased reflux.


What are the principal signs and symptoms of acid reflux in children?


Recognising the symptoms of acid reflux in children is crucial for early intervention. Some of the most common signs include:


Frequent vomiting: Children with acid reflux may spit up or vomit frequently.


Heartburn: Older children may experience a burning sensation in the chest or throat.


Poor weight gain: In infants, difficulty gaining weight or failure to thrive may be a sign of acid reflux.


Chronic cough: A persistent cough, especially at night, can be indicative of reflux.


How is acid reflux diagnosed in children?


Diagnosing acid reflux in children often involves a combination of clinical evaluation and diagnostic tests. Physicians may rely on the child's medical history, symptoms, and physical examination. In some cases, additional tests such as pH monitoring, upper gastrointestinal (GI) endoscopy, or imaging studies may be recommended to assess the severity of reflux and potential complications.


Are medications prescribed for acid reflux in children?


Treatment for acid reflux in children typically involves lifestyle modifications and, in some cases, medication. Doctors may recommend:


Dietary changes: Adjusting the child's diet to reduce trigger foods can be beneficial.


Positioning during feeding: For infants, keeping them in an upright position during and after feeding can help minimise reflux.


Medications: In certain cases, doctors may prescribe acid-reducing medications, such as proton pump inhibitors (PPIs) or H2 blockers, to alleviate symptoms.


Can acid reflux in children lead to complications?


While most cases of acid reflux in children are mild and can be managed effectively, untreated or severe cases may lead to complications. These can include oesophagitis (inflammation of the oesophagus), respiratory issues, and difficulty swallowing.


Can acid reflux be outgrown?


In many cases, acid reflux in children improves as they grow older. As the LES matures and eating habits change, symptoms often subside. However, persistent or severe cases may require ongoing management and medical intervention.




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By Dr Abraham Neduvamkunnil

Dr Abraham Neduvamkunnil is a highly experienced consultant paediatrician and educator at Nottingham University hospitals. Having received the National Merit Scholarship from the Indian government and the Appreciation Award for excellence in Paediatrics by the Ministry of Health, Oman, he began his career with the diverse population in the UK.

For the past two decades, he has served patients in the UK and taught medical students and paediatric trainees. As an experienced paediatrician, he manages a wide repertoire of medical conditions beginning in the new-born period and through adolescence. He specialises in the management of acute and common illness in children including child allergies, eczema, wheeze, asthma, constipation, bedwetting, abdominal pain, urine infections, growth and nutrition, feeding disorders, food intolerances, fits, headache, developmental concerns, and chronic fatigue and tiredness in children.

Dr Abraham values patient confidentiality, holistic approach and patient centred care. He enjoys the role of being the educational supervisor for paediatric trainees. He also serves in the panel of examiners for post graduate paediatric trainees and International medical graduates. In addition to teaching, he values evidence-based medicine and is the clinical audit lead for paediatrics and serve on the governance committee at the busy tertiary Nottingham Children’s Hospital.

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