Data gathering
GOR is common in infants due to their anatomy, supine positioning and frequent liquid feeds. Only 5% suffer from pathological reflux with a risk of pulmonary aspiration. 50% of babies with GORD are likely to have underlying cow’s milk allergy.
PPIs should only be considered after a cow’s milk elimination diet has been trialed without success.
History
- Feed refusal
- Back arching
- Coughing
- Distressed behaviour
- Faltering growth
- Chronic cough
- Hoarseness
- Pneumonia
- CPMA – eczema, GI symptoms, FH of atopy
Examine
- Abdomen
- Hydration status
Clinical management
Investigations
Treatment
- Anti-reflux formula – Carobel
- Gaviscon infant (1-2 week trial) – can cause constipation
- Health visitor – weight, feeding assessment
- PPI (2-4 week trial) if CMPA ruled out
- Safety net: projectile vomiting, yellow/green vomit, blood in vomit, faltering growth, regurgitation beyond 1 year of age