Pediatric reflux seems to be increasingly frequent during primary childhood due to immaturity of the development of both the sphincter and upper and lower esophageal . Fortunately, most babies do not develop problems that require further evaluation or intervention, and most grow out of this condition by the end of their first year of life. However, a minority may have more serious or even life-threatening symptoms or complications.
Generally, the typical approach to pediatric reflux management includes modifications in all patients and pharmacological treatments in those who do not respond to the former. Surgery is reserved only in exceptional cases, as many babies and children respond fortunately to conservative measures such as diet and lifestyle modifications,
Behavioral Modifications:
- Changing the composition of food: thickening of milk and preparations with starch, cereals, carob thickeners, or xanthan gum improves the signs and symptoms of reflux disease.
- Breastfeeding: nursing infants have less esophageal reflux and regurgitation.
- Use smaller and more frequent parts, maintaining an appropriate daily total amount of formula or breast milk.
- Avoid feeding just before bedtime.
- Adjust the diet of the child or mother (in case of breastfeeding) to eliminate malnutrition and substances that increase the transient relaxation of esophageal sphincters, such as chocolate, caffeine, alcohol, mint, mint, fried and fatty foods, etc.
- Avoid sour or spicy meals or drinks, such as citrus fruits and juices or tomatoes and tomato-based foods. Carbonated beverages can cause gastric swelling and should also be avoided. Keeping a food/beverage intake journal is often helpful.
- Treating functional constipation: treatment of constipation in children with the use of a high-fiber diet, behavioral education, or laxatives may reduce acid reflux.
- Elimination of secondhand smoke. Tobacco is a common cause of reflux in adults, and environmental smoking was also implicit, causing reflux in infants and newborns.
- Keep a child in a relatively vertical position for at least 30 min. after feeding.
- Bed head elevation can be used in preschool and school children, but is not recommended in infants and children under two years of age, as it is uncertain that it helps reduce reflux and still suffers risk of suffocation.
Clinical practice
The fact that reflux symptoms in childhood are common shows the importance of personalized care and care that should be taken by parents and health professionals. Behavioral changes impact the lifestyle of the whole family and contribute to early diagnosis and treatment, in addition to avoiding the use of medications such as “that expose the
health of this population at a vulnerable stage of life.
referencesBody
Study suggestion: Discover
the relationship between nutrition and gastroesophageal reflux – Science Play
Watch the video on Science Play with Aline David:
Food Introduction Sofokleous V, Papadopoulou A-M, Giotakis E, Delides A, Kyrodimos E, Maragoudakis P, Psarommatis I. Pediatric Laryngopharyngeal Reflux in the Last Decade: What Is New and Where to Next?
. Journal of Clinical Medicine
. 2023; 12(4):1436.
