Gastric reflux is a common symptom of food allergy.
I see lots of babies with Gastric Reflux. A lot can be done to help these distressed babies get better.
What is GORD/ GERD?
Crying distressed babies often have treatable reflux.
It can often be triggered by a food allergy/ intolerance,
Gastric reflux is when acid regurgitates from the stomach into the gullet (also called oesophagus).
It can be painful: it can burn the oesophagus. Adults call this pain, “heartburn”.
There are two spellings for this:
“Gastro Oesophageal Reflux Disease” (GORD) and
“Gastro Esophageal Reflux Disease” (GERD).
You can imagine how a baby would react to this burning stomach acid in the gullet. Your baby will cry with pain, and often will want to drink a little milk (but often will demand small feed, frequently). These babies also often refuse feeds (either breast or formula bottles). Some loose weight, others get overweight because of increased feedings. Vomiting and spilling is usual, but does not always occur. The vomit is sour and can smell of acid.
The good news is that GORD/ GERD can be successfully treated.
1) Positioning – these babies like to be upright as much as possible, especially after feeds. You can elevate the cot.
2) Feeding – they often like small frequent feeds. Thickening the feeds can be helpful for some. About a third have food allergy/ intolerance which needs to be diagnosed.
3) Medications – there are very effective drugs to combat this disease (including: ranitidine, omeprazole, and domperidone). The first step is to reduce the acid in the stomach. Not all children require medication.
Food intolerance can cause GORD/GERD
- Milk intolerance: a third of these babies are allergic or intolerant to cow s milk. They need to go off all cow s milk before they can get better. They frequently need very special milk formulas.
- Gluten-sensitivity: gluten intolerance is a very important factor in reflux disease. Research shows that many toddlers with persistent reflux are usually intolerant to gluten. Getting a blood test for gluten sensitivity (the IgG-gliadin antibody test) can help to sort this out.
Can gluten cause GORD/ GERD (Gastric reflux)?
Amanda says: Dear Dr Ford, I read your interesting article about GORD and gluten sensitivity. I think my daughter who is 15 months old may have a gluten and dairy allergy.
(She suffered from silent gastric reflux since she was six weeks old, and was medicated for this up until around nine months of age with Omeprazole. Although the symptoms have eased off she has developed eczema around her face and is very irritable and grizzly. She occasionally has very loose bowel movements which are quite ‘mucousy.’ The eczema seems to have cleared considerably since removing gluten and dairy from her diet, but still occasionally will flare up again. Possibly something I m eating (she is still breastfed). My daughter also had sleep problems and has only very recently started to sleep through the night).
I am interested to find out more about the possibility of my daughter having a diary allergy and a gluten sensitivity and would be keen to hear your point of view.
Yes, it is my experience that many gastric reflux babies have a problem with gluten and/or dairy. The research studies show that about a third of reflux is triggered by dairy proteins. My observation indicate that at least half of toddlers (1-3 years old) who still have reflux are made worse with gluten.
It is my clinical practice to test all of these children for IgG-gliadin (the gluten antibody) which detects the majority of children with gluten-related disorders. If this test is abnormal, then I suggest a gluten free trial for 3 months. Nearly all substantially improve. Usually they can then come off their medications.
Crying Over Spilt Milk website: check out this website which is committed to provide support and information to families caring for infants and children with gastric reflux throughout NZ.
If your baby cries a lot and gets very distressed, then get checked out for gastro-oesophageal reflux disease (GORD). It is very important to test for cow s milk and gluten intolerance.
The eClinic can also help you with this.