Nancy, 
Perhaps I should have said that most babies misdiagnosed with GERD have food allergies or structural issues. Anyone who works with babies long enough notices trends. Like right now, we seem to have a sudden rash of babies who have incompetent lower esophageal sphincters? Really? I would not be surprised if there might be far more babies with such a phsyiologic cause seen in a NICU setting, but even then, I am not so sure. 

First, in my practice I have seen hundreds of babies who were diagnosed with reflux--more in recent years than in prior years. So, why suddenly, do all these babies have incompetent lower esophageal sphincters? Whenever I see a sudden increase in diagnosis of anything I want to know why. For example, when you increase the numbers of inductions, you will have more babies born late pre-term who feed poorly--so you can see the cause in obstetrical practices of such a rise in this problem. 

So, why would there be a rise in reflux or GERD? I personally think there are two reasons. I believe that once there is a "diagnosis" for something, it gets applied more often and when there is a drug to match that diagnosis, it becomes the magic bullet. So, yes I think part is drive by the pharmaceutical companies. 

But, I also think there is a legitimate and very real increase in food allergies and sensitivities among babies. For many reasons--inlcuding the rise in obstretrical interventions in birth, which deprive every cesarean-borne baby of his mother's vaginal flora. Including increased exposure to abx during labor and delivery which damages both mother and baby's gut. Bottom line, mothers having babies today are not healthy--more often than not their own intestinal flora is compromised or even utterly destroyed due to their own medicalized births, artificial feeding in infancy, the SAD, use of abx and other medications and exposure to toxins. 

When the gut is damaged, inflammatory cytokines travel through the bloodstream to the brain, where they cause inflammation and activate an immune response, which quiets the information to the part of the brain that delivers information to the gut--reducing vegas nerve stimuli and peristalsis (which is why so many babies suddenly stop pooping at a few weeks of age) --in the case of the mother--these cytokines also travel into her milk and into baby's gut--where they cause inflammation--in the baby's case to his own brain. This is the epidemic we are encountering--not a sudden increase in incompetent lower esophageal sphincters.

On her website, OB/Gyn Marcelle Pick writes "intestinal bloating,                            frequent bouts of diarrhea or constipation, gas and pain, heartburn and acid reflux                            are early signs of an inflamed digestive tract". She goes on to state that a pro-inflammatory diet is a key factor in this process. In her book, the SuperAllergy Cookbook, Lisa Lundy writes that it is her experience that "many food allergy babies are misdiagnosed with acid reflux or GERD". Unfortunately, most anyone who has made the connection (holistic and integrative medicine practitioners and a lot of parents) is not in control of the treatment of babies, and the mainstream literature is sorely lacking in anything that doesn't promote drug therapy. 

In my practice, I have seen babies come in on reflux meds and within days, they are off the meds, once we isolate the allergens/sensitivities and remove them from mom's diet. Bc the vegas nerve is almost always implicated, and many of these babies have had difficult births, I also send them to a chiropractor. And we implement gut healing protocols for mom and baby. The other factor, of course is TT. I rarely see a TTd baby who does not have poor gut function. As far as I have observed, babies do not have deficiencies in acid reflux meds and they do not all have incompetent lower esophageal sphincters. They do, however, pretty much all have damaged guts. In a NICU population, that would have to be just about 100%. 

Perhaps you might consider some alternative structural therapies and gut healing for the babies and their moms? I would love to hear the results, especially given that I also think maternal inflammation underlies almost all milk production imbalances. 


 

Jennifer Tow, IBCLC, France
Intuitive Parenting Network, LLC




Date:    Fri, 3 Jun 2011 23:46:30 EDT
From:    [log in to unmask]
Subject: GERD

 
"GERD is  caused by food allergies and/or structural problems. "

What is the evidence for this statement?  In infants, the research  (and 30 
years as a neonatologist) suggests it is an incompetent lower esophageal  
sphincter (which most babies grow out of) or other neurologic problems which  
underly the GER.  Rarely we will see a baby with an esophageal hernia or  
minor diaphragmatic eventration with GER.  I know nothing of GERD in  adults. 
I have seen no evidence to suggest "food allergies" have anything to do  
with GER in infants.
 
Nancy
Nancy E. Wight MD, IBCLC, FABM,  FAAP
Neonatologist
Sharp Mary Birch Hospital for Women and  Newborns
Medical Director, Sharp HealthCare Lactation Services
San Diego,  CA 
[log in to unmask] (mailto:[log in to unmask]) 


 



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