January 23, 2015

Understanding Reflux and Colic in Infants

Does your baby experience occasional reflux or regurgitation?

Reflux and regurgitation are defined as discomfort caused by the passive return of gastric contents into the esophagus. Regurgitation is reported in 40-64 percent of all infants at four months old but is reduced to one percent by 12 months.

Although reflux and regurgitation are common, they shouldn’t have an impact on your child’s growth or your daily routine.

If your infant has severe or prolonged discomfort from reflux, he or she may be diagnosed with Gastroesophageal Reflux Disease (GERD).

Infants with GERD are characterized by poor weight gain, signs of esophagitis, pulmonary and neurological symptoms.

Signs of esophagitis include persistent irritability due to pain, feeding issues and anemia. Pulmonary symptoms may include a persistent cough, apnea or noises when breathing called stridor or wheezing. Neurological symptoms may mimic mild to moderate hypertonicity and include extensor thrust or arching backwards as well as neck tilting typically to the right which can be mistaken for torticollis.

Conservative treatment of GERD may be managed by your pediatrician and implemented by your child’s occupational, physical or speech therapy team.

Therapy may include positioning during and after feedings for optimal digestion, use of a reflux wedge, thickening formula, changing formula, changing to smaller more frequent feedings or switching to a feeding on demand schedule (when your baby cries in hunger instead of feeding on the clock).

If these do not work, your child’s doctor may prescribe medication such as Reglin or Propulsin and in extreme cases when conservative management is ineffective, surgical interventions may be warranted.

Colic is a condition where your baby has recurring periods of extreme irritability, crying that is inconsolable for hours at a time, often in the afternoons.

There is often no explanation for colic in otherwise healthy infants but it may be undiagnosed GERD, an allergy or milk allergy, lack of proper healthy bacteria (or flora) in your baby’s gut, or slow abdominal motility.

Infants with colic experience extended periods of high-pitched crying that seem inconsolable.

Through pediatric therapy, your child may respond to various calming techniques or positions. He or she may even respond to infant massage, which is a holistic approach that enhances treatment of reflux, constipation and colic through skin to skin stimulation by promoting:

  • Release of hormones for food absorption and digestion
  • Improved sensory awareness, midline orientation and improvement in muscle tone
  • Bonding and attachment which fosters a peaceful loving feeling between baby and caregiver
  • Healthy self-esteem and respect
  • Neurological/physiological effect on sleep patterns, cardiac and respiratory output
  • Increased confidence of caregivers to follow their intuition and read baby’s cues

If your child is experiencing reflux or colic, contact the Epic Pediatric Therapy clinic near you for support in navigating this frustrating period of your child’s development.

Erin Williams
Physical Therapy Supervisor
El Paso, Texas

References: 

  • Jung A. Gastroesophogeal reflux in infants and children. Am Fam Physician. 2001 Dec 1; 64(11):1853-1861.
  • IAIM Certified Infant Massage Instructor Teaching Guide