GERD: Beyond Spitting Up

Up to 85 percent of premature infants have GERD, a digestive disorder that makes the early months tough on parents. While GERD is one of the most common problems among preemies, most babies outgrow it. Until then, there are things parents can do to minimize its effects.


By Christina Elston


Here's a riddle: What could make a mom prefer walking her beat as a New York City cop to staying home with her baby? Answer: GERD.


Gastroesophageal reflux disease is an extreme form of something that happens to all babies - food traveling backward from the stomach to the esophagus, the tube between the mouth and stomach. GERD is "spitting up" that's persistent and accompanied by pain and crying, weight loss, or difficulty breathing. And for preemies, it's a common problem.


A Problem for Preemies


Because the systems in their bodies that coordinate digestion are still immature, premature babies are more likely than full-term infants to have reflux. It's estimated that 65 percent to 85 percent of premature babies reflux, according to Joseph Levy, M.D., director of the division of pediatric gastroenterology at New York University School of Medicine. This compares with just 10 percent to 20 percent of full-term babies.


Luckily, the condition can often be dealt with at home. One study of otherwise-healthy premature babies who could suck and swallow on their own found that while 60 percent had reflux, just 3 percent to 10 percent had reflux that required medical treatment, according to neonatologist Alice K. Gong, M.D., of University Health System in San Antonio. "Most babies will outgrow this just fine," she says.


But while full-term babies can outgrow reflux in as little as six weeks, for a preemie it might take as long as a year, according to Rula Harb, M.D., a pediatric gastroenterologist at Children's Hospital Los Angeles.






Reflux Clues

Some babies have reflux, but no associated problems. But the Children's Digestive Health and Nutrition Foundation suggests talking with your pediatrician if your baby has:


  • Vomiting that includes blood (bright red streaks or anything that looks like coffee grounds) or green or yellow fluids.
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  • Poor weight gain.
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  • Crying or arching away from the breast or bottle, or refusal to feed.
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  • Choking, coughing or gagging during feeding.

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