Tuesday, September 2, 2008

Researching GERD

I did some research on GERD to see what we can do to help Karston.

Gastroesophageal reflux in infants

  • 15 - 40% improve on a milk-free diet, have casein allergy
  • casein allergy tends to go away at 1 year of age
  • PPI generally more effective than H2 blocker

We saw delayed weight gain (is it "delayed" when he's 3 years old and still smaller than the 2-year-olds at his preschool?), projectile vomiting when he was an infant, and he was hungry all the time (day and night).

However, don't be too fast to medicate. Don't be too slow either, or you'll be in our boat with a small child used cuddles all night and food whenever he wants!

Gastroesophageal reflux disease in children and adolescents

  • raise head of bed
  • avoid chocolate, peppermint, and acidic juices like OJ
  • PPIs more effective

Karston often complains that his tummy hurts, he pounds his chest at odd times, and he really likes a firm adult hand on his tummy (think Napoleon's ulcer pose).

Poor weight gain in infants and children

  • eat often: 3 meals and 3 snacks, about every 2-3 hours

During catch-up growth, the amount of calories and protein that a child eats is more important than the variety of foods eaten. For example, if a child is willing to eat chicken nuggets and pizza, but refuses all vegetables, this is acceptable. At meal and snack time, solid foods should be offered before liquids. Fruit juice should be limited to four to eight ounces of 100 percent juice per day.

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