Causes | Seeking help |Home remedies| Treatment |Recovery Outlook
Silent Reflux
Silent reflux, also known as laryngopharyngeal reflux (LPR), involves the contents of the stomach that flow back into the larynx (voice box), the back of the throat, and the nasal passages.
The word "quiet" comes into play because reflux does not always cause external symptoms.
Repeated stomach content comes back into the stomach instead of being expelled from the mouth, which can be difficult to detect.
It is common for children under a few weeks to have reflux. If the reflux persists beyond one year or it causes adverse side effects to your child, their pediatrician may recommend treatment.
Does my child have quiet reflux?
One in five children will have reflux disease. While gastroesophageal reflux disease (GERD) and LPR can coexist, the symptoms of silent reflux are different from other types of reflux.
In children and young children, the most common signs are:
Children with quiet reflux may not spit, which makes it difficult to determine the cause of their distress.
Older children can describe what looks like a sore throat and complain of bitter taste in their mouths.
You may also notice the barbarity in your child's throat.
Reflux vs. Gastroesophageal Reflux Disease (GERD)
LPR is different from GERD.
GERD primarily causes irritation of the esophagus, but silent reflux can irritate the throat, nose and voice box.
What causes quiet reflux?
Children suffer from reflux - whether it is GERD or LPR - for several reasons.
Children have esophageal sphincter muscles that do not develop at birth. The muscles at each end of the esophagus open to allow them to obtain fluid and food.
As they grow, the muscles become more mature and co-ordinate, which is where the stomach matters. This is why reflux is more common in young children.
Children also spend more time on their backs, especially before they learn to roll over, which can happen between the ages of 4 and 6 months.
Lying on the back means that there is no gravity advantage to help children keep food in the stomach. However, even in children who have reflux, you should lie on your back with their baby - not their stomach - to reduce the risk of ocular cramps.
Infants' mostly liquid diets also contribute to reflux. Recovery of liquids is easier than solid food.
If your child is at high risk for reflux:
Born with a hiatal hernia
Have a neurological disorder, such as cerebral palsy
Contains a family history of reflux
When seeking help
Most babies thrive despite a quiet reflux. Get medical help if your baby is:
Difficulty in breathing (for example, you may notice shortness of breath, painful breathing, or your baby's lips turn blue)
Frequent cough
Persistent ear pain (you may notice irritation and pulling of ears in the baby)
Eating is difficult
Difficulty with weight gain or unexplained weight loss
What can I do to maintain or prevent quiet reflux?
There are several steps you can take to reduce your child's reflux.
The first is to modify your diet if you breastfeed. This will help reduce your child's exposure to certain foods that are allergic to them.
The American Academy of Pediatrics (AAP) recommends that eggs and milk from your diet improve for two to four weeks to see if reflux symptoms improve.
You may also consider eliminating acidic foods such as citrus fruits and tomatoes.
Other tips include:If your child is drinking formula, switch to a hydrolyzed protein or amino-acid based formula.
If possible, keep your child upright for 30 minutes after feeding.
Burp your baby several times during feeding.
If you are bottle-feeding, hold the bottle angled to fill it with nipple milk. This will help your child breathe less air. Swallowing air increases intestinal pressure and leads to reflux.
Try different nipples to see what gives your child the best impression around their mouth.
Feed your baby in small quantities, but often. For example, if you feed your child a formula of 4 ounces every four hours or a mother's milk, you are trying to provide 2 ounces every two hours.
How to treat silent reflux
If treatment is needed, your child's pediatrician may recommend GERD medications such as H2 blockers or proton pump inhibitors to help reduce the amount of acid produced by the stomach.
The AAP also recommends the use of prokinetic agents.
Prokinetic agents are drugs that help increase the movement of the small intestine so stomach contents can be drained faster. This prevents food from sitting in the stomach too long.
How long does it take to resolve quiet reflux?
Most children endure quiet reflux by the time they become one.
Many children, especially those who are immediately treated at home or with medical interventions, have no lasting effects. But if sensitive throat and nasal tissues are often exposed to stomach acid, it can cause some chronic problems.
Chronic problems for persistent, uncontrolled reflux may include recurrent respiratory problems:
Pneumonia
Chronic laryngitis
Persistent cough
Rarely, it can lead to laryngeal cancer.
Should I worry about my child's reflux?
Reflux, including silent reflux, is very common in children. In fact, it is estimated that 50 percent of infants experience reflux within the first three months of life.
Most babies and young children will suffer from reflux without any permanent damage to their esophagus or throat.
When reflux disorders are severe or chronic, there are a variety of effective treatments for your child to go through for healthy digestion.
Silent Reflux
Silent reflux, also known as laryngopharyngeal reflux (LPR), involves the contents of the stomach that flow back into the larynx (voice box), the back of the throat, and the nasal passages.
The word "quiet" comes into play because reflux does not always cause external symptoms.
Repeated stomach content comes back into the stomach instead of being expelled from the mouth, which can be difficult to detect.
It is common for children under a few weeks to have reflux. If the reflux persists beyond one year or it causes adverse side effects to your child, their pediatrician may recommend treatment.
Does my child have quiet reflux?
One in five children will have reflux disease. While gastroesophageal reflux disease (GERD) and LPR can coexist, the symptoms of silent reflux are different from other types of reflux.
In children and young children, the most common signs are:
- Breathing problems, shortness of breath, “noisy” breathing or shortness of breath (apnea)
- gagging
- Nasal congestion
- Chronic cough
- Chronic respiratory conditions (such as bronchitis) and ear infections
- Difficulty breathing (your child may have asthma)
- Difficulty in eating
- Spitting
- Failure to thrive can be diagnosed by your doctor if your child grows older and does not gain weight
Children with quiet reflux may not spit, which makes it difficult to determine the cause of their distress.
Older children can describe what looks like a sore throat and complain of bitter taste in their mouths.
You may also notice the barbarity in your child's throat.
Reflux vs. Gastroesophageal Reflux Disease (GERD)
LPR is different from GERD.
GERD primarily causes irritation of the esophagus, but silent reflux can irritate the throat, nose and voice box.
What causes quiet reflux?
Children suffer from reflux - whether it is GERD or LPR - for several reasons.
Children have esophageal sphincter muscles that do not develop at birth. The muscles at each end of the esophagus open to allow them to obtain fluid and food.
As they grow, the muscles become more mature and co-ordinate, which is where the stomach matters. This is why reflux is more common in young children.
Children also spend more time on their backs, especially before they learn to roll over, which can happen between the ages of 4 and 6 months.
Lying on the back means that there is no gravity advantage to help children keep food in the stomach. However, even in children who have reflux, you should lie on your back with their baby - not their stomach - to reduce the risk of ocular cramps.
Infants' mostly liquid diets also contribute to reflux. Recovery of liquids is easier than solid food.
If your child is at high risk for reflux:
Born with a hiatal hernia
Have a neurological disorder, such as cerebral palsy
Contains a family history of reflux
When seeking help
Most babies thrive despite a quiet reflux. Get medical help if your baby is:
Difficulty in breathing (for example, you may notice shortness of breath, painful breathing, or your baby's lips turn blue)
Frequent cough
Persistent ear pain (you may notice irritation and pulling of ears in the baby)
Eating is difficult
Difficulty with weight gain or unexplained weight loss
What can I do to maintain or prevent quiet reflux?
There are several steps you can take to reduce your child's reflux.
The first is to modify your diet if you breastfeed. This will help reduce your child's exposure to certain foods that are allergic to them.
The American Academy of Pediatrics (AAP) recommends that eggs and milk from your diet improve for two to four weeks to see if reflux symptoms improve.
You may also consider eliminating acidic foods such as citrus fruits and tomatoes.
Other tips include:If your child is drinking formula, switch to a hydrolyzed protein or amino-acid based formula.
If possible, keep your child upright for 30 minutes after feeding.
Burp your baby several times during feeding.
If you are bottle-feeding, hold the bottle angled to fill it with nipple milk. This will help your child breathe less air. Swallowing air increases intestinal pressure and leads to reflux.
Try different nipples to see what gives your child the best impression around their mouth.
Feed your baby in small quantities, but often. For example, if you feed your child a formula of 4 ounces every four hours or a mother's milk, you are trying to provide 2 ounces every two hours.
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| Identifying and Treating Silent Reflux in Infants |
How to treat silent reflux
If treatment is needed, your child's pediatrician may recommend GERD medications such as H2 blockers or proton pump inhibitors to help reduce the amount of acid produced by the stomach.
The AAP also recommends the use of prokinetic agents.
Prokinetic agents are drugs that help increase the movement of the small intestine so stomach contents can be drained faster. This prevents food from sitting in the stomach too long.
How long does it take to resolve quiet reflux?
Most children endure quiet reflux by the time they become one.
Many children, especially those who are immediately treated at home or with medical interventions, have no lasting effects. But if sensitive throat and nasal tissues are often exposed to stomach acid, it can cause some chronic problems.
Chronic problems for persistent, uncontrolled reflux may include recurrent respiratory problems:
Pneumonia
Chronic laryngitis
Persistent cough
Rarely, it can lead to laryngeal cancer.
Should I worry about my child's reflux?
Reflux, including silent reflux, is very common in children. In fact, it is estimated that 50 percent of infants experience reflux within the first three months of life.
Most babies and young children will suffer from reflux without any permanent damage to their esophagus or throat.
When reflux disorders are severe or chronic, there are a variety of effective treatments for your child to go through for healthy digestion.
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