Children's Health

Gastroesophageal Reflux Disease (GERD) in Infants or Children

What Are the Treatments for Acid Reflux in Infants and Children?

There are a variety of lifestyle measures you can try for acid reflux in babies and older children:

For babies:

• Elevate the head of the baby's crib or bassinet.
• Hold the baby upright for 30 minutes after a feeding.
• Thicken bottle feedings with cereal (do not do this without your doctor's approval).
• Feed your baby smaller amounts of food more often.
• Try solid food (with your doctor's approval).

For older children:

• Elevate the head of the child's bed.
• Keep the child upright for at least two hours after eating.
• Serve several small meals throughout the day, rather than three large meals.
• Make sure your child is not overeating.
• Limit foods and beverages that seem to worsen your child's reflux such as high fat, fried or spicy foods and caffeine.
• Encourage your child to get regular exercise.

If the reflux is severe or doesn't get better, your doctor may recommend medication.

Drugs to Lessen Gas in Babies and Children

Drugs to lessen gas include:

• Simethicone such as Mylicon
• Gaviscon

Drugs to Neutralize or Decrease Stomach Acid

Drugs to decrease stomach acid include:

• Antacids such as Mylanta and Maalox
• Histamine-2 (H2) blockers such as Axid, Pepcid, Tagamet, or Zantac
• Proton-pump inhibitors such as Nexium, Prilosec, Prevacid, Aciphex, and Protonix.

Researchers aren't sure whether decreasing stomach acid lessens reflux in infants.

For the most part, drugs that decrease intestinal gas or neutralize stomach acid (antacids) are very safe. At high doses, antacids can cause some side effects, such as diarrhea. Chronic use of very high doses of Maalox or Mylanta may be associated with an increased risk of rickets (thinning of the bones).

Side effects from medications that inhibit the production of stomach acid are uncommon. A small number of children may develop some sleepiness when they take Zantac, Pepcid, Axid, or Tagamet.

Drugs to Improve Intestinal Coordination

Drugs to improve intestinal coordination include:

• Propulsid. This drug was voluntarily withdrawn from the U.S. market in 2000 due to an association with abnormal heart rhythms; however, it is still available when prescribed under the guidance of a specialist in gastrointestinal diseases and can be very effective for treating childhood reflux. The drug works by increasing the pressure of the lower esophageal sphincter and increasing emptying of the stomach and the rate that food moves through the intestines. This helps reduce esophageal exposure to stomach contents.
• Reglan. This is another medication that helps speed up the digestion process. However, it is also associated with many side effects, some of which can be serious.
• Erythromycin. This is an antibiotic usually used to treat bacterial infections. One common side effect of erythromycin is that it causes strong stomach contractions. This side effect is advantageous when the drug is used to treat reflux.