Reflux and I are not friends. When my twins were 2 months old, they knew how to fall asleep independently, but would have random crying episodes in the middle of the night, lasting anywhere from 1 to 10 minutes (but never longer), and with no rhyme or reason.
Googling anything I could think of, and at my wits' end, I called a fellow mom of multiples. "Maybe it's silent reflux," she suggested.
So I googled that. Hm. Looks like it might be. So I called their pediatrician, spoke to the nurse, and she relayed what I told her to the doctor... and then over the phone, they diagnosed and prescribed medication.
I was shocked, and a bit horrified.
Thankfully, we did away with their "reflux" (which I'm not entirely sure that it was) without medication, but Reflux and I are still not friends.
And that's because, these days I feel like reflux is such a common diagnosis - perhaps even an over-diagnosis - that may turn parents away from what is actually causing the symptoms they're seeing.
The over-diagnosis is likely caused by a combination of aggressive pharmaceutical marketing, lack of experience and information transfer across generations, and parents simply seeking a label for their child who is always fussy, irritable, cries a lot, demanding or feeding resistant.
GERD, or Gastro Esophageal Reflux Disease, is an easy diagnosis to throw out, and "reflux" and "reflux disease" have become synonymous... even though they are NOT.
Reflux, when some food comes back up the esophagus, is very common in babies. Their bodies are so little, and the bottom of the esophagus (Lower Esophageal Sphincter) starts out too weak to keep everything down. So, some of it'll come up - either as spitting, projectile or silent. That is normal.
Can I say that one more time? SPITUP IS NORMAL. Really. About 50% of newborns (0-3 months) have some sort of reflux and 67% of babies 4-5 months old. That does NOT mean, though, that all of those kids are in pain. Only about 20% of children with reflux have true GERD.
Remember - reflux and reflux disease (GERD) are NOT the same.
Medical consensus is that GERD should not be considered before 3 months of age (so my babies who were 2 months... yeah... they should not have been diagnosed and medicated.) Additionally, there is no evidence to support using acid suppressants in infants - even on a trial basis - and the majority of infants on reflux medication do not meet diagnostic criteria.
Many symptoms of GERD can occur due to a variety of reasons, and don't necessarily mean that a child has a reflux condition. Medications are not recommended in infants under 12 months of age (and have not been tested on infants!). The official medical protocol is "Watchful Waiting" until one year of age; which, unfortunately, many parents are unaware of, and many pediatricians do not adhere to.
So, in summation, there are a lot of reasons your child may be spitting up. And there are a lot of reasons your child may be fussy or crying - and those two reasons do not necessarily coincide. Just because your kiddo is spitting up and is fussy does not mean that he has GERD, and making a "diagnosis" of a medical problem without first addressing the myriad reasons for frequent regurgitation is irresponsible and unethical.
Oh, and in case you're wondering - yes; we switched to a new pediatrician before their 4 month visit.