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Aspiration

Reflux Precautions for Infants

  • Elevate the head of the bed to a 30 degree angle and position the child in a prone position (on tummy). This helps to minimize the night refluxing and aspiration. This can be achieved in a variety of ways. You can put the head of the mattress on the top rung of the crib and the bottom of the mattress on the bottom rung.  You can also put a pillow under the crib mattress. You can also put something stable under the legs of the crib, bed or bassinet.
  • Thickening of feeding has been recommended for years as therapy for reflux in infants. This can be achieved by adding infant cereal to breast-milk or formula. The usual amount is between 1 and 3 teaspoons cereal per ounce of formula or breast milk. Rice cereal can be used but will often cause constipation so oatmeal is recommended. Also--if you are using powdered formula, try switching to a thicker variety--concentrate or the thickest of them all, ready-to-feed. Also, remember that breastmilk is of a thinner consistency than either concentrate or ready-to-feed formulas, so a little more cereal may be needed.
  • Avoid tight or constricting clothing
  • Eliminate exposure to secondhand smoke.
  • Keepthe child upright for 30-45 minutes after feeding.
  • Avoid laying the child flat as much as possible.
  • Talk to your pediatrician about trying  Mylanta or another over the counter antacid. Children's Mylanta is not good for refluxers as 1) it contains calcium which will aggravate reflux and 2) it is designed for occasional upset stomach not for daily use.

Reflux Precautions for Children

  • Avoid supine (back laying) or semi seated position
  • Elevate head of bed
  • Fast before sleeping
  • Avoid large meals (smaller but more frequent feedings instead)
  • Diet - if overweight or obese (obesity has been linked to reflux)
  • Avoid tight fitting clothes
  • Avoid tobacco smoke
  • Avoid medications that decrease the LES (Lower Esophageal Sphyncter) pressure or increase gastric acidity
  • Avoid adrenergic medication
  • Avoid anticholinergics
  • Avoid calcium-channel blockers
  • Avoid prostaglandins
  • Avoid xanthenes (caffeine, theophylline)

    Avoid foods that decrease the LES pressure or increase gastric acidity. such as:

  • alcohol
  • coffee or anything with caffeine
  • carbonated drinks
  • fatty foods
  • citrus fruits (and citrus fruit juices)
  • tomatoes
  • chocolate
  • mint



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