GORD Flashcards
What is GORD?
Contents from the stomach reflux through the lower oesophageal sphincter into the oesophagus, throat and mouth.
What causes GORD in infants?
Due to immaturity of the LOS in infants.
Risk factors for GORD?
preterm delivery, neurological disorders.
When should infants stop having reflux?
12 months
What is normal reflux?
- Normal for babies to have some reflux after larger feeds. Typically develops <8 weeks.
- Milky vomits after feeds. May occur after being laid flat.
What are signs of problematic reflux?
- Chronic cough.
- Hoarse cry.
- Distress, crying or unsettled after feeding.
- Reluctance to feed.
- Pneumonia.
- Poor weight gain.
What is posseting?
Baby will not be bothered by it
Smal amnt of milk brought back up into mouth, regurg or spilling
normal
How to manage unconcerning reflux up to 12 months?
Reassurance (very common, normally resolves by 12m) + Advise → small + frequent feeds,
burping regularly to help milk settle,
not over-feeding,
keeping baby upright after feeding
What are the indication to further review reflux?
projectile regurgitation
bile-stained vomit
haematemesis
faltering growth
difficulties feeding
persistent beyond first year of life.
How to manage mum and baby is they are breastfeeding and baby has normal reflux?
- 1st → carry out breastfeeding assessment.
- Trial smaller but more frequent feeds.
- 2nd → if issue still persists: 1-2 week trial of alginate therapy (gaviscon).
How to manage mum and baby is they are bottle feeding and baby has normal reflux?
- 1st → review feeding history. Reduce feed volumes if excessive for infant’s weight.
- 2nd → trial of smaller but more frequent feeds.
- 3rd → trial of thickened formula or anti-regurgitant formula.
- 4th → alginate therapy (gaviscon).
What pharmacological measures may be tried if nothing else works?
2-4 week trial of PPI or histamine agonist if → unexplained feeding difficulties, distressed behaviour, faltering growth, no resolution despite trial of alginate therapy.
