This article is written by reflux parents for the benefit of reflux parents, based on their own experiences. It is not meant to replace medical advice and is of a general nature only. If you have any questions or concerns, please seek advice from your medical professional.
Myth: Babies with reflux just need to be positioned upright, and you just have to ‘deal with it’ until it passes.
Reality: Some reflux babies are helped enormously by being positioned upright for feeds and immediately afterwards, and for some this may be the only treatment they need. For others, their reflux can be severe enough that further treatments are required. It may be unfair on baby to allow them to suffer from reflux or its complications because you have been told they would grow out of it and you just had to ‘deal with it’ until then.
Myth: Reflux in babies does not cause pain like it does in adults
Reality: While some babies do not get pain from their reflux, others do. Some adults liken it to drinking battery acid, except that the acid comes up from the stomach. The same can happen with babies and their oesophageal lining can also suffer damage.
Myth: Your baby has reflux because you are stressed/uptight
Reality: Your baby does not have reflux because you are uptight or stressed, although your stress may impact on your child. Generally, you are uptight and stressed out because of your child’s reflux; you do not cause it, and their reflux is not your fault.
Myth: Your child will eat when they are hungry; no child will starve itself
Reality: While it is true that most children will eat when they are hungry, it may not be true for children with reflux. Some infants and children with reflux can, and do, stop eating in an attempt to stop the pain or nausea. They may have learnt to associate eating with their discomfort, and refuse to eat. These children need to have their reflux controlled before they are comfortable eating, and some require extensive therapy even after their reflux is controlled. A small percentage of infants and children need to be fed by tube so they can grow and develop appropriately.
Myth: Once the reflux goes away, it is gone for good
Reality: In most children, reflux signs generally disappear sometime in the first eighteen months to two years. They do occasionally continue or recur in some children, with many parents reporting their child’s reflux flares when they become ill, are immunised, teething, out of routine, constipated, or overtired. It may also happen when they crawl (as they are often in a horizontal position), when they lose their baby teeth, or cut their adult ones. For some children, it may look like their reflux is improving because their signs go away. Sometimes this just means that their signs have changed, and reflux may still be a factor (e.g. a child who vomited may no longer do so, but can still be refluxing significantly). At a later date, it may become apparent they are refluxing, but it may also be a continuation, rather than a recurrence.
Myth: Reflux is all about spitting up; if they don’t spit up/vomit, they don’t have reflux, or their reflux is not severe
Reality: It is not possible to judge the severity of a child’s reflux, or whether they have reflux, based on their vomiting. There are many different ways that reflux presents, and even though regurgitation/spitting up/vomiting are common in reflux, not all children with reflux do. Some children who do not vomit or spit up (“silent reflux”) can have severe reflux; while some children who do vomit may have very mild reflux.
Myth: A Baby who vomits a lot has reflux
Reality: A baby who vomits a lot, or has any other presentation of reflux, may not necessarily suffer from reflux. They may have another condition such as an infection or a metabolic disorder that can present similarly to reflux. It is important that any child who vomits is assessed by a doctor for an accurate diagnosis.
Myth: Medications such as omeprazole (e.g. Losec) must be crushed for a baby
Reality: The granules in omeprazole and similar medications are enteric coated. They are broken down in the intestine and must be intact as they pass through the stomach. As a result, crushing or chewing them reduces their effectiveness, as can administering them in breast milk or infant formula. For further information, speak to your pharmacist.
Myth: Reflux medications control reflux and stop vomiting
Reality: Reflux medications are used to prevent symptoms and help healing by reducing the amount of acid the oesophagus is exposed to. This does not cure reflux, nor stop your child from vomiting. Some children respond well to them, and may do so almost immediately; however, some children may not show improvement for several weeks, if at all. It can take time to find the right combination and dosage of medication that is effective for your child. If any inflammation is present, improvement can take even longer.
Myth: Reflux can be cured by surgery
Reality: There is no cure for reflux (apart from time in some cases); and surgery is generally used as a last resort in managing reflux. It can improve a child’s quality of life, but it is not a perfect solution and it is performed only in specific circumstances.
© Glenda Blanch, RISA Inc member and author of “Reflux Reality: A Guide for Families” 2010.
Information reviewed by Associate Professor Anthony Catto-Smith, Paediatric Gastroenterologist.