Gastroesophageal Reflux in Premature Infants

If an infant is in pain, has slowed or stopped eating, or has apnea or bradycardia that is caused from reflux, more aggressive management needs to be done. Medications such as Zantac or Tagamet that decrease or block the production of acid, and/or Reglan which improves digestion, may be prescribed. These medications are often used in combination with one another; however, they should not be given in conjunction with some types of antibiotics because of the risk of serious side effects. In any case, check with your physician or pharmacist before giving your baby any medications for reflux.

Most children will out grow GER by one year of age. As children grow, their esophagus becomes longer and the stomach naturally begins to wrap around the muscle at the top of the stomach. It will also help when your child spends more time in an upright position as she develops.

At any age, if the symptoms are significant and medical intervention does not control the reflux, surgery may be needed. The surgical technique can vary, but the general purpose is to create an artificial sphincter at the top of the stomach by wrapping a small part of the stomach around the esophagus. Traditionally, surgery is done by using a two- to three-inch incision in the middle of the abdomen. Some surgeons perform the surgery laproscopically using four 1/2 inch incisions on the abdomen.

Choosing to have surgery is not an easy decision. Discuss all your options with your pediatrician, GI specialist, and surgeon. If possible, talk with other parents whose child has had surgery for reflux. Evaluate whether the surgery will help your child's pain and growth, and if the benefits from the surgery will out weigh any possible complications. Complications can include gagging and retching after eating, a slight decrease in the stomach volume, scarring and/or infection at the surgery site.

Having a child with reflux can trigger many emotions. It is normal to feel anger, frustration, and sadness. Sometimes it helps to talk with those who can empathize with you and understand your feelings and concerns, such as other parents of children with reflux. You'll need support to make it through these difficult days. A national parent support group called PAGER (Pediatric Adolescent Gastroesophageal Reflux Association, Inc.) can help you find any further assistance you might need. They can be contacted at their website or they are located at PO Box 1153, Germantown, MD 20875-1153, (301)601-9541.

Dianne Maroney spent over 17 years working as a neonatal intensive care nurse. She recently received her masters of Science in Psychiatric/Mental Health Nursing from the University of Colorado Health Science Center in Denver. Dianne is the co-author of Your Premature Baby and Child: Helpful Answers and Advice for Parents" (Berkley, 1999). She is also the mother of a premature infant, born 3 1/2 months early. As a national speaker and a member of many local and national organizations, she works with medical professionals and parents advocating to further incorporate a parent perspective and family needs into the care of the pre-term infant and child, both in the NICU and at home.

Copyright © Dianne Maroney. Permission to republish granted to Pregnancy.org, LLC.