Does anyone know anything about reflux in toddlers?

[DesertFox]

My DS is 18 months and at night often wakes up in a lot of distress. He's never been a great sleeper, but he really seems to me like sometimes he's in pain.
I took him to the doc and she suggested it might be reflux (made worse at night cos of lying down...). It seemed to fit exactly, he has bad breath when he wakes up and sometimes sounds like he is gagging / swallowing, but the stuff she prescribed (gaviscon infant) didn't seem to help and when I went back and saw a different doc she said she didn't think it was reflux. I still think it might be - the symptoms seem right.
Does anyone know anything about it, recognise the symptoms, have any ideas of how to treat it if it is that (I'm thinking maybe diet related...?) We've got a pillow under the sheet in his cot to try to raise him up a bit.

[LIZS]

does he have milk just before bed. Might help to give it earlier or in a different thicker form such as porridge. Perhaps offer main meal at lunchtime so he has time to digest it and give him something lighter for tea.

Definitely good idea to prop up mattress. Did he have reflux as a baby as I've not come across it developing later before .

[alliebaba]

does he have stomach ache, can u tell at that age?

[Chapsmum]

The bad breath could be an indicastion of a bug like helicobactor pylori, have you or you partner ever had this?

[Chapsmum]

hi allie, long timr no see!

[alliebaba]

my bf ds had bad breath and a tender tummy.. probably scare mongering but he had a gangrenous appendix

[alliebaba]

hello hen!

[Chapsmum]

scare monger, you are right allie, persistant tummy pain should be taken v v seriously! especailly in one soo young!

[nulnulcat]

if it is reflux is he sleeping on his back? dd has had reflux since birth is 2 now and has near enough grown out of it still have our moments though! she has always slept on her stomach and even when i put her down on her back she straight away turns over its comfier for them if he wont sleep on his front try to encourage him to sleep on his side

[alliebaba]

dr baba, reporting for duty! they wouldn't have detected it if he hadn't been run over by a cyclist, apparently cos it was gangreen you don't get as much pain, but stinky breath, he is 7 though so a little older!

[Chapsmum]

AMAZING ALLIE, WOULD NEVER HAVE THOUGH BEING RUN OVER WAS A GOOD THING BUT THERE YOU GO!

[Chapsmum]

sorry cap lock on didnt mean to shout!

[SueW]

My DD developed bad breath at 5yo and was initially diagnosed with reflux, wrongly. She has achalasia which was causing food to get stuck in her oesophagus and rot in there. She pointed to her mid chest area and said it hurt when she swallowed - but this was about a month after the bad breath started.

After a couple of months of smelly breath she started to bring back her food as the sphincter at the top of her stomach had closed up so much and she had lost the contractions (peristalsis) which carry food to the sotmach. Some people with achalasia find their food overspills into their trachea when they lay down which causes them to cough/gag at night.

It's unlikely that your son has this problem as it is rare in adults and even more rare in children (1 in 300,000 approx) but it is one possibility. In the end my DD was diagnosed by barium swallow and the cons said achalasia was one of about 20 possible problems. If your GP is fumbling in the dark, ask for a referral to a paed gastroenterologist at your local hospital.

[DesertFox]

LIZS, He didn't have it as a baby - hardly ever puked at all. Still doesn't actually throw up, just sounds like he is swallowing something back. He does have milk just before bed, and evening meal at 5ish.

Alliebaba, He could tell me in the daytime if he had a sore tummy but at night doesn't seem to be able to communicate so well, so I'm just not sure.THink if was gangrenous appendix we would know by now tho as has been going on for months!!!

What's this helicopter pylon bug you speak of chapsmum? Don't think have ever had, will check with DP... The bad breath is only at night, not really there in day.

Nulnulcat he moves around alot, is hard to tell how he normally sleeps as usually by the time I get there he is sitting up... but he does draw his knees up sometimes which I think could indicate pain...

[LIZS]

Bad breath could be a symptom of a multitude of causes from a blocked mucousy nose resulting in breathing through the mouth, build up of plaque in the mouth, tonsillitis to gastric problems. If he has a cold does he gag more ?

[Chapsmum]

helicobactor ppylori is an ulcer cuasing bacteria which would explain the late onset of heartburn like symptoms. It is transfered via salyvia and is uncommon but not unheard of in children, it can be diagnosed by a breath test and treated withantibiotics.

[nulnulcat]

i may be wrong but i dont think reflux is something that just develops as it tends to be bad in babies and improves once they start solids and the muscles get stronger

[alliebaba]

that's the weird thing. bf couldn't work out why his breath smelled and he didn't really have any pain. it was only after a couple of months, after he was run over by a nutter on a push bike, that it brought the problem to light! sure it's not that, but just a little yarn for ya!

[Chapsmum]

I suspect what you are looking for is the cause development of heart burn rather than reflux,if indeed that is the cause. the sphincter that is troublesome in causing reflux usually becomes developed enough not to cuase problems by toddler age, unless the child develops a hernia or picks up a stomach type bug like hp.

[katyrocks]

just a thought - ds was checked out for 'pyloric stenosis' - a condition where the flap at the top of the stomach doesn't close properly (i think) - hence the reflux, more common in little boys

[SueW]

pyloric stenosis usually develops in infants around 6 weeks of age, more often in boys than girls. Characterised by 'waves' across the abdomen that can be observed when feeding and projectile vomiting. Pyloric sphincter is at the bottom of the stomach where it empties to the intestines.

Reflux in infants usually starts at birth and gets better at 18m-2y when the lower oesophageal sphincter (LOS) becomes stronger. As people get odler e.g. approaching middle age reflux and heartburn may start again. Approx 40% of adult popluation gets heartburn/reflux!!!

DD's LOS doesn't function - it remains closed - but has now had op to remain open all the time. Because she doesn't eat cr*p, doesn't overeat or drink lots of alcohol (!) she at the mo avoids heartburn.

[katyrocks]

he was very small - and it was because of projectile vomiting as well, i just noticed the thread and it reminded me. but I thought it was the top of the stomach!

[DesertFox]

LIZS He hasn't had a cold for ages so I'm not sure.

All these medical things are possible, though I'm pretty sure he wasn't having the prob as a baby so think the things that generally develop when they're tiny are less likely. The thing is the last 2 docs I saw were basically just shrugging their shoulders and saying it's very hard to tell and that's what children do (waking in the night and getting upset etc), I think they thought I was a bit of a neurotic mum... So feel a bit reluuctant to go back!!! Tho obviously will if it seems DS has anything nasty...

Chapsmum, I think that's it about looking for the cause of heartburn... I keep wondering whether I'm feeding him something that's causing it - he eats a good range of stuff - usually in the evening (5ish) I give him beans on toast, broccoli / cauliflower cheese, dippy egg and brown toast, banana, yoghurt, that kind of thing...

Meant to mention that the bad breath seems to have gone a bit by morning which makes me think it is associated with the digestion of his food.