Vomiting

GERD: Is Your Infant Suffering from Acid Reflux?

Infant With Gerd (Acid Reflux)

Acid reflux, or GERD (gastroesophageal reflux disease), in infants can be worrisome for you and uncomfortable for your baby. Although GERD is rarely serious in infants and will typically resolve on its own by age 1, it’s important to know how you can help your baby and what the treatment options are. Here’s what you need to know about acid reflux in infants.

What Causes GERD in Infants?

Acid reflux in infants is caused by food and acid in the stomach traveling back up the esophagus into the mouth. The reflux may cause irritation to the esophagus and cause your baby to spit up excessively or vomit. GERD is usually the result of a digestive system that has not yet fully matured. Because of this, once the digestive system is fully developed around one year of age, your baby’s symptoms should resolve on their own. Typically, infants who suffer from acid reflux are otherwise healthy.

Symptoms of GERD in Infants:

While spitting up is a normal daily occurrence in infants up to and even occasionally beyond six months, these symptoms may suggest your infant is suffering from acid reflux:

  • Spitting up or vomiting excessively and often throughout the day
  • Crying during or immediately after feedings
  • Frequent gas/belly pains
  • Fussiness at the breast or bottle
  • Gagging or choking while eating
  • Persistent Coughing

How Do Doctors Diagnose GERD in Infants?

More often than not, your baby’s pediatrician will be able to diagnose acid reflux based upon the symptoms alone. Typically, any further testing will not be necessary. If the pediatrician is concerned that the issue may extend beyond an immature digestive tract, he or she may recommend further testing.

Testing may include:

  • X-rays of the digestive tract: Your baby may be given barium in a bottle to highlight possible obstructions to the digestive tract on the X-ray images.
  • Ultrasound: to rule out pyloric stenosis.
  • Blood and urine samples: to rule out the possibility of infections that may cause vomiting.
  • Esophageal PH monitoring: This is a procedure in which a small tube is inserted into baby’s esophagus through the nose or mouth to monitor acidity levels. This may require hospitalization.
  • Upper endoscopy: This procedure is typically done under general anesthesia and involves placing a small tube with a camera lens into baby’s esophagus, stomach and small intestine to rule out the presence of obstructions or other complications.

Most babies will not require the above testing and a diagnosis should be possible based on symptoms alone.

How Can I Help My Baby Feel Better?

Having a baby who suffers from acid reflux can make a parent feel helpless. There’s nothing worse than seeing your baby in pain and not being able to solve the problem. Fortunately, there are a few simple things you can do to help reduce your baby’s GERD symptoms. These include:

  • Slightly elevating baby’s head: Instead of lying baby flat to sleep, place a wedge under the crib or basinet mattress to give his head a slight boost. Many moms and dads love the Fisher Price Rock N Play Sleeper for keeping a baby with acid reflux slightly propped. Baby should always be placed on his back to sleep.
  • If bottle feeding, offer more frequent but smaller meals.
  • Burp baby often during feedings.
  • Keep baby upright for 30 minutes following a feeding.
  • Some pediatricians may recommend adding one teaspoon of rice cereal to baby’s bottle if bottle feeding. There are conflicting opinions on this approach before six months of age so be sure to consult your pediatrician and do your research before trying this option.
  • If you are breastfeeding, try adjusting your diet by strategically eliminating things like dairy, caffeine, beef, eggs, etc., that might be contributing to your baby’s reflux.
  • If formula feeding, try experimenting with different formulas. Consult your pediatrician for recommendations.
  • Use bottles that eliminate baby’s air intake such as Dr. Brown's.
  • If your baby is still experiencing a considerable amount of discomfort despite the above changes, your pediatrician may prescribe simethicone or a calcium carbonate antacid to further reduce his symptoms.

In extreme, but rare cases, GERD may cause breathing problems and even pneumonia. There is a surgical option available in which the surgeon wraps the top part of the stomach around the esophagus to form a block that prevents reflux from occurring due to stomach acidity. This, however, is a very uncommon and rarely necessary procedure for infants.

If you have questions about acid reflux in infants or would like information about natural birth, pregnancy and postpartum services or women’s care, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center. We are here to support you through your pregnancy and beyond.

Listeria and Pregnancy: What Is It, Symptoms, and How to Avoid Infection

Listeria and Pregnancy

Listeria is one of those scary words during pregnancy that you’ve heard but may not be exactly sure what it is. You probably know the basics about what foods you should not eat to avoid infection but what is listeria, exactly? And why is listeria so dangerous for pregnant women and their unborn babies? 

These are all excellent questions and a great place to begin when educating yourself about these dangerous bacteria. Here are the basics about listeria and why it is crucial that you take steps to avoid these bacteria while pregnant. 

What is it?

Listeria is a form of bacteria that can be found in uncooked vegetables, fruits and meats, unpasteurized milk and cheeses and processed foods. Listeria moncytogenese can originate in water and soil and animals can also act as carriers for the bacteria. When food comes in contact with listeria, it is considered contaminated and the bacteria can only be killed by cooking the food to the proper temperature or through pasteurization. 

Why is there an increased risk for pregnant women?

When a person becomes ill from the bacteria listeria, they are said to have listeriosis. While this is a rare condition, pregnant women are approximately 10-20 times more susceptible to infection than non-pregnant adults. Contracting listeriosis during pregnancy can result in serious complications for both mom and baby including miscarriage, premature delivery, infection to the newborn, and in extreme cases fetal or maternal death. As many as 1/5 cases of listeria infection in pregnant women result in stillbirth or neonatal death.

What are the symptoms of listeria infection?

Symptoms of listeriosis can begin as early as several days after exposure or as late as one month later. They may include:

  • Mild flu like symptoms
  • Headaches
  • Fever
  • Vomiting or diarrhea
  • Muscle pain

Fortunately with early detection, an aggressive antibiotic regimen can help prevent the infection from crossing the placental barrier and infecting the baby. This can greatly reduce the chances of severe complications like miscarriage or stillbirth. If you suspect you may have become infected with listeria, contact your doctor immediately who can perform a blood test to check for the presence of the bacteria.

How can I avoid listeria infection while pregnant?

With extra attention to what you eat and proper food safety and handling, you can greatly reduce your risk of coming in contact with the bacteria listeria while pregnant. Here are some tips to preventing infection during pregnancy and keeping you and your baby healthy:

  • Skip deli meats and hot dogs unless reheated to steaming (160 degrees F)
  • Avoid soft cheeses that may not be pasteurized such as Brie, feta, goat cheese, Camembert, 
  • Mexican cheeses (queso fresco, quesos blanco and panela), and blue-veined cheeses. Hard cheeses and semi-soft cheeses like mozzarella are fine, as are cream cheese and cottage cheese.
  • Do not eat pate or other cold meat spreads
  • Do not eat refrigerated smoked salmon unless it has been cooked in a dish.
  • Keep food prep areas clean
  • Wash your hands before eating or handling food
  • Cook foods to their proper internal temperatures
  • Keep your refrigerator clean and set at 40 degrees or less
  • Wash fruits and veggies thoroughly before eating
  • Avoid raw or uncooked meats and seafood
  • Refrigerate and freeze leftovers promptly.

For more foods to avoid during pregnancy, check out this article. 

Although it is important to take measures to avoid listeria during pregnancy due to the potential for serious complications, remember that instances of listeriosis are extremely rare. In the US, approximately 1,700 people each year become infected with the illness of which only 17 percent are pregnant women. With a healthy, pregnancy conscious diet and safe food handling practices, there is no need to be fearful of listeria infection. Listeriosis is fortunately very preventable in most cases. For questions about maternal and fetal health, natural birth or any and all pregnancy related topics, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Morning Sickness

Morning sickness Morning sickness (which can actually strike any time of day or night) is a common but challenging ailment of pregnancy. Seventy-five percent of all pregnant women experience some degree of morning sickness—aptly called Nausea and Vomiting in Pregnancy.  Many women experience a general feeling of nausea, while half of all pregnant women feel sick enough to vomit.

Morning sickness often develops at 4 to 6 weeks and resolves around 14 and 16 weeks, although few women experience intermittent or continuous symptoms throughout pregnancy.  Hyperemesis gravidarum is the name for such serious cases.

On a scale from one to five, most women rate their symptoms at about a 2 or 3, which is very uncomfortable but still tolerable. Morning sickness can drastically affect even the simplest daily tasks, as well as diet, professional life, sleep, relationships, and emotional health.

Though the causes of morning sickness are not entirely understood, some believe it actually serves a protective function for your baby.  Some evidence suggests women who experience nausea/vomiting have a lower risk of miscarriage (although lack of sickness doesn’t increase the risk).  That said, nausea and vomiting can be uncomfortable if not debilitating and should be discussed with your provider.

While any pregnant woman may experience morning sickness, the following are thought to increase a woman’s chances:

  • motion sickness, migraines, or birth control-related nausea/vomiting prior to pregnancy
  • morning sickness with a previous pregnancy
  • carrying twins or multiples
  • female family members experienced morning sickness
  • carrying a girl (one study found severe nausea to be 50% more common in women carrying girls)

Naturopaths believe that the severity of nausea is associated with maternal liver health.

Here’s how to cope:

FOODS

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  • Choose high-carb, high-protein, low-fat, easy-to-digest foods.
  • Salty foods can help some women
  • Avoid greasy, spicy and fatty foods if they aggravate your symptoms
  • Yeast supplements and products can aggravate morning sickness
  • Eat small, frequent meals and snack often—an empty stomach can aggravate sickness; eating small amounts often can help maintain blood sugar levels, thought to ease nausea. Dried and fresh fruits and nuts are good snacks to have on hand.
  • Some women swear by eating dry foods, like a few soda crackers, a piece of dry toast, whole grain ginger biscuits, or rolled oats upon waking in the morning
  • Eat slowly
  • Avoid “trigger” foods or smells—while nutrition is important in pregnancy, be kind to yourself, listen to your body, and stick to foods that appeal to you and don’t aggravate your symptoms.
  • Take prenatal vitamin with food or at night if it seems to upset your stomach, Health Foundations carries prenatal supplements that are generally well-tolerated

FLUIDS

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  • Sip water often, mostly between meals (especially if you have been vomiting)
  • Some women find lightly carbonated, electrolyte-containing, or sour drinks to be helpful
  • Water with lemon promotes a balanced alkaline system
  • Sip broths, barley water
  • Ginger tea and other forms of ginger can allay nausea
  •  Peppermint, chamomile, fennel and raspberry leaf tea can also reduce symptoms and provide nutrients (caution: peppermint can aggravate heartburn)
  • Avoid coffee and orange juice, they can aggravate symptoms and strain the liver

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LIFESTYLE

  • Get fresh air and exercise (even though it may be the last thing you want to do, even a short brisk walk can help)
  • Try not to lie down right after eating
  • Sleep or rest as much as you can, this can reduce symptoms
  • Determine and avoid your non-food related “triggers”: such as a warm room, strong odors, changing positions quickly, flickering lights, car rides, etc.
  • Aromatherapy—place a few drops of lemon, ginger, or peppermint essential oil on a cloth/tissue and inhale
  • Deep diaphragmatic breathing can improve liver and gall bladder functioning.  You can also massage under the base of the ribcage for pressure relief
  • Avoid stress as much as possible

OTHER HELPFUL TREATMENTS

acupressureNausea

  • Vitamin B6 supplements can help ease nausea and vomiting
  • Acupuncture/acupressure (sea bands) may help
  • Hypnosis has some proven benefit in alleviating nausea
  • PrimaBella: available at Health Foundations, this FDA-approved device, which is worn like a watch, has helped many women
  • Medications: if your symptoms are severe or persistent or your nutrition is greatly compromised by morning sickness, don’t be afraid to speak with the midwives about medication options that can help

PrimaBella

When to call the midwives:

While you should definitely speak with the midwives about your nausea and vomiting, the following are cause for a more immediate call:

  • Nausea or vomiting is severe
  • You feel dizzy or faint when you stand up
  • You pass only a small amount of urine or it's dark in color
  • Your heart races
  • You vomit blood
  • You can't keep down liquids

Remember, as bad as morning sickness can be, this too will pass, sweet mama!