Clearing up some misconceptions.

I've been hearing a lot of misconceptions lately regarding infant reflux, and I wanted to try to be informative on this topic (as I've done quite a bit of research on the topic).

• First, acid reflux is pretty common in babies. There is nothing "wrong" with these babies -- it is simply that the valve at the top of the stomach that keeps acid from backing up into the esophagus is not strong enough yet. One estimate states that as many as 50% of babies have reflux in their first three months of life. For the vast majority of babies, reflux does not cause pain. Most babies will outgrow this condition (as the valve strengthens) by 5 or 6 months. Nearly all babies will outgrow it by 12 to 18 months. So, this is not a lifelong condition.

• Some babies (like Ava) spit up forcibly through their nose and mouth once or more a day after eating. This in itself is not a concern unless the baby is not gaining weight or is in pain. Signs of pain include screaming while trying to eat, screaming after spitting up, hard belly, arched back, and flailing limbs when eating, and irritated nasal and esophageal passages. Ava has all of these symptoms. Luckily this does not happen every time she eats (mostly about twice a day), but it is heartbreaking to watch.

• Reflux is not caused by the type of formula, the type of water used, the type of bottle used, etc. There are other conditions (like a milk allergy) that can be affected by the type of milk or formula given -- luckily Ava does not have any of these conditions. Her reflux persists no matter what type of formula, bottle, or water we use. Changing feeding positions can help, and keeping the baby upright for 20 minutes after eating is helpful. We also elevated one side of Ava's crib mattress, so she sleeps on an incline.

• The medication for reflux does not control the reflux itself -- it simply neutralizes the acid to make it less painful. She will not be on this medication forever. Imagine that you have heartburn so bad that you can feel it in your nose and throat. You would take something for it (like Tums or Maalox), right? Well, that's why we give Ava zantac. It simply helps to control the pain (by neutralizing the stomach acid) until she outgrows this on her own. The problem we are having right now is that the zantac is no longer working. There are better medications for reflux (prevacid is one), but pediatricians like to refer to a specialist to prescribe them. We are seeing a specialist (a pediatric GI doctor) on February 10th.

I hope that helps to clarify what we (and Ava) are dealing with. I know that there are others out there who may not agree with this diagnosis or our choice to give Ava zantac. However, I ask that you please keep these opinions to yourselves. We are the ones who have to see Ava in pain every day, and we trust our own instincts and well as Ava's wonderful pediatric team. We are doing what we think is best for our daughter.