Is acid reflux more common in premature newborns?

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Premature infants have an increased risk of developing Gastroesophageal Reflux (GERD). GERD is the backward flow of stomach contents into the esophagus. It is commonly caused by the immature muscles and abnormal breathing that are often observed in preterm babies. Usually, their lower esophageal sphincter is weak or underdeveloped and is likely to remain open when it should be closed. Hence, stomach contents could flow back into the esophagus. Acid from the stomach would irritate the tissues within the esophagus causing them to be inflamed. Babies then experience pain and could affect their eating (as they want to avoid the pain). Symptoms of GERD include: - spitting up frequently (more than 2 times a day) - fussy often throughout the day (specifically before, during or after eating) - refusing to eat - resisting eating - taking only small amounts of formula or food, regardless of the amount of time since the last feeding - back arching during feedings - bradycardia - choking or apnea during or after eating - skin color turns pale or grayish during or after eating - poor weight gain - frequent respiratory infections Here are some tips that may help with feeding and to minimize spit-ups: - Hold baby upright during feeding - Try smaller, more frequent feedings - Burp baby often, especially if feeding with a bottle - Try a different nipple on the baby's bottle so he/she swallows less air - Consult the doctor if the formula could be thickened or whether expressed breast milk could be mixed with a small amount of rice cereal - Keeping baby still after feeding Here are some articles that are useful in understanding GERD in premature babies:

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