Acid Reflux in Newborn and Testing

Updated on August 15, 2008
J.O. asks from Orlando, FL
16 answers

Hello everyone, thank you for responding to my questions last week about my 5 weeks olds acid reflux! I got several great ideas. She is still having severe trouble though and the pediatrician has just ordered something called a swallow test for her. I need to know more about this test! I just found out that she will not be able to eat for four hours before the test!! That is killing me!!! They also kind of tie her down from what i understand. Is this really going to help find out the problem? Am I doing this in vein? If anyone knows anything about this test please let me know!!!!!

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J.J.

answers from Tallahassee on

Hello J.. You can relax about the swallow test. My daughter had it at about the same age. It will diagnose the problem, if there is one, and it is better to know and be able to treat it because she is probably experiencing allot of discomfort now. I also think that the earlier they can do the test, the better. Older babies will want to fight it. It isn't cruel in any way, so you can rest easy.

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E.O.

answers from Tallahassee on

I'd ask if a test is absolutely necessary or if there is any other test they can try. Both of my kids have reflux and my oldest actually has esophagial problems and neither of them have ever had to have a swallow test done. They have both been on Zantac since shortly after they were born and recently my oldest was prescribed Prevacid in addition to it for the reflux as well as Flovent for his esophagus problems that were determined by an edoscopy. Try asking for something different. You don't want to put her through a test like that if they can dianose her without it and from my personal experience they should be able to diagnose her without testing and put her on meds that will help the reflux.

GOODLUCK!!!

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S.E.

answers from Jacksonville on

I am a ragiologic technologist and I just want to help you understand that this test is not so bad.
This test is varied a little because your baby is so small they will have to restrain her to get the results they need (but it is not done painfully)..always remember they are trying to make your baby feel better.
What is a barium swallow?
A barium swallow is a diagnostic test which involves a series of X-rays of the esophagus, stomach, and duodenum during and after drinking a barium solution. The duodenum is the first part of the small intestine; and the esophagus, stomach, and duodenum are collectively called the upper gastrointestinal (GI) tract or upper digestive system. You may also hear doctors refer to a barium swallow as an "upper GI series" or a "barium meal".

Parts of the Body Involved
Esophagus
Stomach
Duodenum
Why does my child need a barium swallow?
A doctor may order a barium swallow when his or her patient suffers from one of more of the following symptoms:

Diarrhea
Weight loss
Abdominal pain
Difficulty swallowing
Regurgitation (vomiting)
Rectal bleeding
Bloody stools (bowel movements) or black, tarry stools
Bloody vomit, or vomit with a "coffee-ground" consistency
A barium swallow can help detect:

An ulcer
A blockage
An abnormal growth or tumor
Diverticula – an abnormal pouch or sac opening from a hollow organ, such as the intestine
Gastroesophageal reflux disease (GERD)
A hiatal hernia
Crohn's disease
Pulmonary aspiration – inhalation of fluid, food, or other foreign matter into the lungs
Inflammation of the stomach or small intestine
What is it like to have a barium swallow?
Prior to Procedure

Review your child's medications with your doctor. There are some that your child may need to stop taking before the barium swallow test.
For at least four ro eight hours before the test, your child may not eat or drink-based on the childs age.
Your child may be given a medication called glucagon to slow down the activity of the stomach and small intestine.
Your child may be asked to swallow baking soda crystals (only for older children). These will bubble and produce gas in his or her stomach, allowing for more detailed X-rays.
If your child is going to have a small bowel follow-through, you may need to give your child a laxative medication the day before his or her exam, in order to clean out the small intestine. Check with your doctor.
During Procedure
Your child will need to remove any jewelry, and change into a hospital gown. He or she will then drink a barium sulfate solution. This is a thick, white, chalky milkshake-like liquid that coats the inside lining of the esophagus, stomach, and duodenum.

As your child drinks the barium, a radiologist takes X-rays of the upper GI area, using a machine called a fluoroscope. If the doctor wants to examine the esophagus, he or she may have pictures taken as your child actually swallows the liquid or small bits of food that are covered with barium. Your child will be asked to change positions frequently in order to coat the entire surface of the GI tract with barium.

If the radiologist wants to examine more of the small intestine, a small bowel follow-through may be done. For this exam, X-ray pictures are taken every 15–30 minutes while the barium travels through the intestine.

There is usually no pain associated with the procedure, so anesthesia is not given. Some people dislike the taste of barium, while others are not bothered by it. A barium swallow can take between 30 minutes and two hours. A small bowel follow-through can take one to four hours.

After Procedure
Your child may eat and drink as usual after his or her barium swallow. Unless your child is an inpatient at the hospital for another reason, there is no hospital stay involved.

Have your child drink lots of fluids to eliminate the barium from his or her system.

What happens next?
A normal barium swallow will show an unobstructed, functioning, healthy digestive tract. Examples of abnormalities that may show up on a barium swallow include obstructions, ulcers of the esophagus, stomach or small intestine, or irregularities in the swallowing mechanism. Your child's doctor will make treatment recommendations based on the findings
This test is painless...and will help you make your sweet baby fell better by getting her diagnosed.

1 mom found this helpful
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M.H.

answers from Fort Walton Beach on

Hi J.,

I missed your request before but wanted to let you know that slippery elm bark works wonders for acid reflux and is absolutely fine for infants. You can get it at the health food store. Also if there is any esophageal damage it will also heal that too. (I used it on my elderly mom when she had esophageal damage from the Fosamax they give for bone density... It healed immediately. Of course I took her off the Fosamax to prevent further damage.)Diet also, whether it's formula or your diet for breast milk, is critical. My youngest had acid reflux at that age and I wish I had know this then.

As far as the test goes, I would try to dodge anything that is traumatic and also will only give you a diagnosis it seems you already have. There are no pharmacueticals that "cure" acid reflux, only a few that band-aid the problem and cause more problems down the road.

Take care and God bless!

M.

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L.G.

answers from Jacksonville on

My daughter had the test done when she was your daughters age. We scheduled it first thing in the morning and I never thought she'd be able to go 4 hours but she ate during the night about 4 hours before and we had to get her up to go to the appointment earlier than normal for her schedule. She was hungry by the time they had it set up, she had been breast fed only so I was very relieved that she took the bottle. I don't remember them having to tie her down. They may have put her in a papoose but at that age she won't be rolling over so they may not have to do it at all. Rememember, these techs are trained to work with babies and should be very understanding of your fears. It was a blessing to actually know what was wrong with her, we started her on medicine and she did wonderfully. My older son was so bad he had bubbles coming out his nose and quit breathing 3 times on us from the reflux when he was very small. I was never told about this test from his former doctor which really upset me after I was told about it from my daughers doctor. Remember to prop her up after a feeding for as long as possible, the soft bouncy seats worked best for me. Good luck Mom!

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M.H.

answers from Gainesville on

Hi J.,
Trust your instincts as a Mommy and if you feel something is truly wrong and need a diagnosis, then move forward with the test. But, if you feel the test is unnecessary and only being used to "rule out" rather than diagnose, I would seek a second opinion before going ahead with it. The only reason I say this is becuase I think it is imprortant to trust your instincts and do what you feel is best for your baby (which might be no test).

My situaltion is slightly different, but with my son, the doctor orderd an MRI when he was a baby, and he had to be anesthetized...couldn't eat for TWELVE hours before the test or two hous after because of anesthesia...had to have a breathing tube...it was awful. I felt nothing was wrong and couldn't believe they needed to do an MRI on a baby that was perfectly healthy just becasue he had a big head. I just went along with what the doctor said and put my little guy through all that for nothing (not to mention the $1000 it cost me - and that was AFTER insurance) I spoke with another doctor - a friend of the family - after the fact, and was told that the ususal protocol, in the absence of other symptoms, is to take a family history, measure both parents' heads, do an ultrasound to check for fluid, check for any developmental delays, and maybe even wait a month and measure again, BEFORE doing an MRI. My doctor did none of this, and in hindsight I wish I would have sought a second opinion when my instincts told me to. After the test, the doctor never even called me. I finally spoke to the nurse after I called a week later, and she said, "yeah, he just has a big head." I already knew that!

It may just may be bad reflux, but if you feel the test is necessary and decide to move forward, just remember that she is so small, she will not remember any of it, and it will be harder on you than it is on her. With my son "not eating" was definitely the hardest part becuase he was too little to understand WHY I couldn't feed him, and that was hard. But, it was all over in a day and we are non the worse for wear. Don't stress about it either way, just do what you feel is best for the health and well-being of your baby.

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H.M.

answers from Orlando on

Hi J.,
Sounds like you may enjoy my parent baby class after your baby's testing reveals answers and suggests right medical treatment. Learn soothing techniques for baby and yourself. I'll give private sessions or come to a group class. You can hostess a little group in your home if you like and that can bring down your tuition.
Take a look at my business listing on Mamasource...Helen's Infant Massage Instruciton. I've been a certified parent educator for years. I'm right here in southwest Orlando and love to teach. You'll see why. Just register. 2- 4months is a great time to begin. Best wishes for happier moments. Helen PS I babysat for 3 sisters: Gina, Jada, and J.
years ago... what a coincidence if you're the youngest sister!

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M.R.

answers from Orlando on

Hi J.,
My daughter also had the same problem. Everyone says it will get better and I know right now it doesn't seem that way. One of the moms here referred me to a pediactric specialist for stomach problems Dr Bargarva ###-###-####
she is really good. She recommended we have a the same test and it was no problem. My baby didn't even cry. They just gave her a bottle of solution to drink and I was right there holding the baby in place, I also watched the monitor with the Dr.

Don't be afraid to get the test its the beginning of comfort for her and peace of mind for yourself...

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S.A.

answers from Orlando on

J.,
What Sheila described is the procedure we had done on our son (our doctor called it an upper GI series) when he was 3 1/2 months old. It was painless and did not seem to bother him at all. During the test we could actually see the barium solution making its way up from his stomach to his throat. It was a relief to know exactly what the problem was and the doctors could then accurately treat his reflux. I understand the stress and anxiety of having a sick baby and not knowing how to help. This test will enable you and the doctors to help your child. I recommend that you get it done so your child can get an accurate diagnosis. It may not be reflux at all but some other type of problem that the test can also reveal. Why sit around and wonder if it's going to get better when you can find out for sure with this test?

Best Wishes!

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T.S.

answers from Panama City on

J.,

If the "swallow test" is called a Motility test, I had this done. I can't recommend to you one way or another, but be prepared for a lot of discomfort for your daughter. She will probably be very upset.
With this test, they put a tube down my nose and into my throat, and then, if that wasn't hard enough to deal with, they pulled it up and down several times (for about an hour, it seemed) to hit my gag reflex and check my swallowing reflexes. I can tell you that I will never take that test again. It was very humiliating, because it makes you feel very vulnerable. If they don't get a good reading because you move too much (from gagging and coughing), they will redo and redo until they get the reading. By the time I left, my face was a mess from eyes watering so much and nose running from coughing so hard and embarrassing enough, my bladder didn't withstand all the gagging and coughing. :-{
Now, if your Dr. wants to do this test because he believes your daughter does have a swallow issue, then you must go forward with it and just give her as much affection as you can. But if he is simply trying to "rule it out", it may not be necessary to put her through.
If this is the same test, they did not give me warning on how they conducted this test and I was blindsided, otherwise I would have prepared myself for it.
I would make sure she has a toy or something to hold onto and be right there with her. Also, make sure she has a good pullup on and one for changing her afterwards.
You could, and I pray you do, have a much better experience than I did. And maybe they have improved the process since I went (a few years ago).
I will be praying for you! When is she supposed to have the procedure?
Take Care and God Bless You,
T.

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M.H.

answers from Melbourne on

Your child has a yeast problem!!!! It was passed to her from you either in the womb or in the birth canal. Has she had Thrush? That is a yeast condition in the mouth and throat. It will be covered in white. Start giving her probiotics--now!! Put the powder in her milk. When she is old enough--1 yr. I believe--feed her yogurt, which is probiotics. But yogurt is not enough. She will also need it in her milk. Check with you local health food store. Once yeast is in the body it is there for life. There is no cure only control with taking probiotics and eating low sugar and carbohydrates (which feed the yeast). If you start now she will have less disease than most in her lifetime.
I am speaking from experience.
Love and God bless you,
M.

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T.M.

answers from Orlando on

Hi. When my little guy had an upper GI done, they told me too that he couldn't eat for 4 hours. I told them they were insane...he was still nursing hourly almost at that point. ugh. This test was also to diagnose reflux/rule out other problems and was MUCH easier for the baby than a swallow study. (I would not do a swallow study on such a small baby personally...there are other options.)

I held his feeding for 1.5 hours before the test and that was all. The reason for holding the feedings is to make sure the baby is hungry enough to drink the contrast formula that is necessary for the test. If you have a baby that is usually hungry, then you don't have to wait anywhere near 4 hours. Just don't argue the point with them. You know your baby and how long she can last. Schedule accordingly.

As far as being held down...YOU can often do that part and most technicians prefer it because if the baby gets upset, they can't do the test anyway. (Hysterical babies won't swallow or feed normally and thus the test can't be done.) With my son, they didn't strap him down at all. They asked me to hold his hands above his head while they took the ex-rays. I wore a lead apron during the procedure. As long as you aren't pregnant, you can do this part and I would insist on it to keep your baby's fear to a minimum.

Also...if you are breastfeeding (the easiest thing for a reflux baby to digest is mom's milk!) then you can bring some pumped milk with you for them to use with the contrast. I didn't want formula to be used (because formula made the reflux worse) so I just brought a bottle of milk from home and they used that.

Make sure when you get there too that they know the baby is already hungry, so you aren't left waiting even longer.

Feel free to email me if you have any questions or want a recommendation for an excellent pediatric gastro doc. :)
____@____.com

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T.P.

answers from Orlando on

I was wondering if the spit up was getting any worse as the days go along. Our son started spitting up and in about a week it got extremely bad where he was THROWING up everyting projectile vomiting up to 4 feet. Can you tell if she is throwing everything up, or just spitting up. Spit up would probably be acid reflux and go with advise from other moms with that experience. Sorry I don't have any info on the test. One thing I do recommend if she is spitting up after meal is to feed her right before going into the doctors office (or while waiting for the doc) to show the doc how much qty she is spitting up, that helps them gauge how serious or not it is.

If every day it is getting worse it could be pyloric stenosis. For our son within one week he got worse everyday. By the time that I could show people that it really was serious and I wasn't being an overreactive new mom he had blood in his urine, yellow eyes and had lost a 1.5 lbs. He was throwing up within 15 min after every meal.
when we got to the hospital they gave him an ultrasound to see if the muscle closed (confirming the phlyoric setonsis)and then gave him an IV and told me I couldn't feed him pedialite or nurse him for 24 hours. they however did give me a thing called "sweet tooth" or "sweet treats" I forgot which (comes in a little container like fast food butter, with the foil lid to peel off, sugar water) that we could dip his pacifier in to sooth him. for not feeding him for 24 hours it was at least something to help with the crying.

Hope that your problem is only reflux, and that the test helps them remedy it quickly and safely.
T.

A.L.

answers from Ocala on

Hi!

My oldest daughter had this test done to my (now 13) Grandaughter when she was about six months. She had many problems as she ingested material on her way down the birth canal and had to have her stomach 'pumped' as a newborn, different types of formula in addition to breast milk, in all the test answered questions about the 'real' reasons for her problems which she 'outgrew' with the help of antibiotics and medications by the time she was about three years of age.
Ask if they can give your child some medication to 'relax' her
that may make the test easier for both of you.

Best of luck!

A.

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B.M.

answers from Pensacola on

my middle child Sophia had acid reflux. the doctor wanted my to stop nursing and give her soy formula and acid reflux medicine and all kinds of crazy things. I found a new doctor and just waited it out. the reflux and projectile vommitting all stopped around 3 1/2 to 4 months. If you can just wait it out that would be my suggestion. As long as your sweet angel is gaining weight than you are good. also a natural remedy that you can find at most health food stores called gripe water seemes to ease any discomfort that Sophia had.
hope this helped. My husband just got used to my new baby spit up hair gel and that fact that I quite possibly had taken two or three showers that day but somehow still managed to look like I hadn't showered in days:) this too shall pass!

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J.A.

answers from Jacksonville on

Hi J.,

Don't worry. The swallow test sounds horrible, but it isn't. They have you not feed for four hours because they will give your child a bottle with the stuff they need to see. This is how ours went:

We went in and they placed my daughter on a papoose board where they wrap them up nice and snug so they can't move, but it doesn't hurt, it's like being swaddled at birth. Then they had me give her the bottle while they watched through the machine as she swallowed, and followed it down to her stomache. They rotated her several ways while doing this to watch how her swallowing and her stomache were working. This is how I found out my daughter didn't have acid reflux, the muscle at the top of her stomache does not work at all, it doesn't close. While this can allow acid to creep up, her problems were not caused by acid, therefore the meds they were giving her made matters worse, not better. It sounds cruel, and looks intimidating, but it was simple, painless, and I got to be with her and reasure her through the whole thing (it took about 15 minutes) and she didn't cry once. It is well worth it to find out exactly what is going on, and treat properly. In about 90% of the cases like my daughter, they outgrow the problem by age one, and the muscles start to work properly. My daughter didn't but it's not a big deal as we know how to deal with it correctly, and without the heavy duty drugs that have not been approved by the FDA for use in such young children. good luck and please let us know how it turns out.

Jay

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