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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Tuesday, February 9, 2010
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Tuesday, February 9, 2010
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Children's Health |
Infant sleep apnea/reflux11/17/2004 |
a friend just had newborn, baby was having problems eating, turning blue. he was diagnosed as having sleep apnea, reflux disease. can you tell me anything about infant sleep apnea, and the reflulx? baby is only a week old. mother is so upset.
Let me start with the good news that 60% of infant reflux resolves by 2 years of age and the remainder by 4 years of age. Now to the problem itself.
Reflux is simply a passive backwash of stomach contents into the esophagus, the tube that carries food from the mouth to the stomach. While this commonly occurs in many older children, vomiting is seldom seen because the volume in their esophagus is greater and the stomach contents remain there. In newborns, the volume of the esophagus is much less and so refluxed feeding appears as vomiting or large spit ups after feedings. Reflux is common in newborns because the circular muscle at the bottom of the esophagus that should close tightly and retain stomach contents is lax.
Some degree of reflux is very common among newborns, but not all require treatment. Among those infants with reflux requiring treatment, 85% present with symptoms in the first week of life, such as your friend's baby, and the remainder by 6 weeks of age. About 1 in 300 infants with reflux also has reflex apnea, or stopping of breathing, when reflux occurs. A more common side effect of reflux is aspiration pneumonia. This is when the refluxed feeding flows into the trachea, or windpipe, and the child inhales drawing the feeding into the lungs where an infection develops. Infants may also experience problems in growth and weight gain if they vomit too much of their feedings.
The usual treatment is to thicken feedings with 1 tablespoon of rice cereal per ounce of breastmilk or formula, to keep the baby's head elevated after feeding by holding or placing the baby in an infant seat, and to place the baby on his or her tummy for sleeping (this is approved by the American Academy of Pediatrics for infants with reflux) on an inclined surface. Typically, parents are told to place pillows under the mattress to elevate the baby's head during sleep. Medications to prevent reflux can also be prescribed. These measures often quickly control the problem.
Reflux is a scary problem for parents. If your friend's baby does not improve on these standard care measures, she should ask for a referral to a pediatric gastroenterologist.
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Mary M. Gottesman, PhD, RN, CPNP, FAAN Associate Professor, Specialty Program Director Pediatric Nurse Practitioner Program College of Nursing The Ohio State University |
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