In order to resolve any child's issue with food refusal the underline medical issue needs to be treated or resolved. In many instances a child with acid reflux disease will also have other overlapping conditions that could be aggravating the problem with feedings. The most common conditions that may precipitate additional issues with feedings are allergies, aspiration or swallowing issues and motility diseases.
Allergies can range from mild to severe. Sometimes the sinuses draining down the throat can cause choking or gagging. In some instances there are food allergies that can irritate the GI tract and make eating more difficult. One allergic condition that mimics acid reflux disease is Eosinophillic Esophagitis. This is usually caused by a food allergy in which the body responds by sending eosinophils (white cells) to the affected area. Only proper allergy testing can rule out any of these conditions as issues for your child.
Aspiration can happen in children with acid reflux as well as children with swallowing difficulties. It is important to determine if the reflux is causing the aspiration or if the swallowing difficulty is causing it. Both need to be treated in order to get a handle on the feeding disorder. A speech pathologist can perform a "swallow study" to determine if your child is swallowing correctly. Sometimes a lung wash will be preformed to determine if the aspirated contents are from the stomach. These issues are treated differently so it is important to determine the source of the aspiration.
Motility diseases occur when the food does not pass through the GI tract at a normal rate. This can leave food sitting in the stomach for longer periods than is normal. This will often lead to more vomiting as well as make the child feel full when they should actually be hungry. Motility medications include Reglan, Bethanachol and Erythromycin. There is some debate on the use of these medications so be sure to do your homework. They come with side effects and have to be used on a case by case instance.
Once you have the entire picture of the cause of your child's feeding difficulty it can make it much easier to facilitate the proper treatment.
Published On: March 19, 2012