Heartburn in children

Overview

Heartburn in children is a burning feeling in the chest or throat caused by stomach acid flowing back up into the food pipe (the tube that carries food from the mouth to the stomach). This backflow is called reflux.

Yes, heartburn is fairly common in children, especially in infants and young children. Many children experience mild reflux, but frequent or severe heartburn needs attention.

Heartburn can affect children of all ages, from babies to teenagers. It is more common in children who have a family history of reflux, are overweight, or have certain medical conditions.

Symptoms

Common symptoms

• A burning feeling in the chest or throat, often after eating
• Sour taste in the mouth
• Burping or belching
• Nausea or feeling sick

Symptoms in children

• Fussiness during or after feeds (in babies)
• Arching the back or crying after eating (in babies)
• Spitting up or vomiting
• Coughing or wheezing, especially at night
• Refusing to eat or poor weight gain

Causes

Main causes

• A weak muscle (lower oesophageal sphincter) that normally closes after food enters the stomach, allowing acid to flow back up
• Eating large meals or lying down soon after eating
• Certain foods and drinks that relax that muscle or increase stomach acid

Risk factors

• Being overweight or obese
• Having a hiatal hernia (where part of the stomach pushes up into the chest)
• Certain medical conditions like asthma or cerebral palsy
• Taking some medicines (like ibuprofen or steroids) – talk to your doctor
• Eating spicy, fatty, or acidic foods, or drinking fizzy drinks and caffeine

When to see a doctor

See a doctor urgently if:

• If your child has any of the emergency symptoms listed above
• If they have severe pain or trouble swallowing

Book a routine appointment if:

• If heartburn happens more than twice a week
• If it wakes your child up at night
• If it is affecting their eating, growth, or daily life

Diagnosis

A doctor will ask about your child's symptoms, eating habits, and overall health. In many cases, no tests are needed. The doctor may also check your child's weight and growth.

Tests that may be done

• pH monitoring – a thin tube placed in the food pipe to measure acid levels over 24 hours
• Endoscopy – a camera on a thin tube to look inside the food pipe and stomach
• Barium swallow – a special X-ray after your child drinks a chalky liquid to see how food moves

What to expect at your appointment

If tests are needed, they are usually done in a hospital or specialist clinic. Most children tolerate them well. The doctor will explain each step and help your child feel comfortable.

Treatment

Treatment for heartburn in children focuses on relieving symptoms and preventing them from coming back. Many cases improve with simple lifestyle changes. If not, a doctor may recommend medicines to reduce stomach acid or help the stomach empty faster.

Self-care at home

• Feed your child smaller meals more often instead of large ones
• Keep your child upright for at least 30 minutes after eating
• Avoid trigger foods like spicy, fatty, or acidic foods, and fizzy drinks
• If your child is overweight, gentle weight loss can help
• Raise the head of your child's bed or cot slightly (with a doctor's advice for babies)

Medical treatments

If lifestyle changes are not enough, a doctor may recommend medicines that reduce stomach acid or help the stomach empty. These are usually taken for a few weeks. Never give your child over-the-counter heartburn medicines without talking to a doctor first, as some are not suitable for children.

When is surgery considered?

Surgery is very rarely needed for heartburn in children. It may be considered if symptoms are severe and do not improve with medicines, and if there is a clear physical problem like a hiatal hernia. A paediatric surgeon would discuss this in detail.

Living with this condition

Heartburn in children is usually manageable with simple changes to mealtimes and routines. Keep a diary of when symptoms happen to identify triggers. Most children grow out of it as they get older.

Lifestyle tips

• Encourage your child to eat slowly and chew food well
• Avoid letting your child lie down right after eating
• Limit foods and drinks that seem to cause symptoms
• Make sure your child gets enough sleep and stays active

Diet and exercise

A healthy, balanced diet with plenty of fruits, vegetables, and whole grains can help. Avoid large meals close to bedtime. Regular exercise helps with digestion and weight management, but avoid vigorous activity right after eating.

Mental health and emotional wellbeing

Living with frequent heartburn can be uncomfortable and may make your child feel worried or embarrassed, especially if it causes bad breath or coughing at school. Reassure your child that it is a common problem and help them talk about how they feel.

Prevention

You cannot always prevent heartburn, but you can reduce how often it happens with healthy eating habits and lifestyle changes. Early treatment of mild symptoms can stop them from getting worse.

Complications

If left untreated

• Oesophagitis – inflammation and damage to the lining of the food pipe
• Strictures – narrowing of the food pipe that makes swallowing hard
• Respiratory problems like asthma or pneumonia from acid entering the lungs

Long-term outlook

Most children with heartburn get better with simple changes and treatment. Long-term problems are rare. With the right care, your child can lead a normal, active life.

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