From the Guidelines
For treating gastroesophageal reflux disease (GERD) in a 10-month-old, start with non-medication approaches like keeping the baby upright for 30 minutes after feeding, offering smaller, more frequent feedings, and thickening formula with 1-2 teaspoons of rice cereal per ounce if recommended by a pediatrician, as suggested by the American Academy of Pediatrics guideline 1. The goal of these lifestyle modifications is to reduce symptoms and prevent complications, while also considering the potential risks and benefits of each approach.
- Key considerations include:
- Modifying maternal diet in breastfed infants and changing formula in formula-fed infants, as certain proteins like cow's milk can exacerbate symptoms 1
- Reducing feeding volume while increasing feeding frequency to decrease pressure on the lower esophageal sphincter
- Thickening formula to reduce regurgitation, although this may not decrease the actual number of reflux episodes 1
- Avoiding overfeeding and considering elimination of cow's milk from the diet if sensitivity is suspected If these measures do not provide adequate relief, medications such as histamine-2 blockers (e.g., famotidine) or proton pump inhibitors (e.g., omeprazole) may be considered, as they can reduce stomach acid production and alleviate symptoms 1.
- It is essential to consult with a pediatrician before starting any medication, as they can provide guidance specific to the baby's condition and monitor for improvement or side effects. Treatment typically continues for 4-8 weeks before attempting to wean off medication, and most infants outgrow reflux by 12-18 months as their digestive systems mature and they spend more time in upright positions 1.
From the Research
Treatment Options for GERD in Infants
The treatment for Gastroesophageal Reflux Disease (GERD) in a 10-month-old infant can be managed through various methods, including:
- Non-pharmacological interventions such as feeding schedule modifications, thickened feeds, changes in positioning, or a trial of formula change 2
- Nutritional management is recommended as a first-line approach in infants 3
- Pharmacotherapeutic agents used to treat GERD encompass antisecretory agents, antacids, surface barrier agents and prokinetics 4
- Esomeprazole (Nexium) is now approved in the US for short-term treatment of GERD with erosive esophagitis in infants aged from 1 to 12 months 4
Pharmacological Treatment
Studies have compared the effects of different medications in the treatment of symptomatic GERD in infants, including:
- Omeprazole and ranitidine, which showed no statistically significant differences in their efficacy for the treatment of GERD 5
- Proton pump inhibitors and H2 blockers, which have been demonstrated to be safe and effective in infants 5
Lifestyle Changes and Parental Reassurance
Effective parental reassurance and education regarding regurgitation and lifestyle changes are usually sufficient to manage infant reflux 4
- Choking, gagging, coughing with feedings or significant irritability can be warning signs for GERD or other diagnoses, and should be evaluated by a healthcare professional 4