How is baby reflux 'officially' diagnosed?

The formal diagnoses that your baby may receive for reflux include:

  • gastro oesophageal reflux (GOR / GER) for reflux
  • gastro oesophageal reflux disease (GORD / GERD) for reflux
  • laryngo pharyngeal reflux (LPR) for silent reflux
  • extra oesophageal reflux (EOR) for silent reflux

Lots of long names for the same thing: regurgitation.

Some babies, like my own daughter, get described as being colicky, with no official diagnosis at all.

However, when they don’t “grow out of it” by the magical 12 week mark, the diagnosis gets upgraded to reflux.

The difficulty, in truth, and according to the 2018 Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (a.k.a. the medical experts), is that…

“Symptoms of GERD are known to vary widely by age and are non-specific. As a consequence proving that reflux events cause one or multiple symptoms is often difficult (1,12). This is particularly true in nonverbal infants in whom defining troublesome is problematic. Reported symptoms of infant GERD vary widely and may include excessive crying, back arching, regurgitation and irritability. Many of these symptoms, however, occur in all babies with or without GERD, making a definitive diagnosis challenging.”

On a side note, I don’t think that it’s at all difficult to define a “troublesome” symptom in a nonverbal infant. Just because they don’t use words does not mean they are not able to communicate with us! 

Back to the question in hand… The diagnosing of reflux. 

As the medical experts rightly point out, the symptoms in infants with reflux (and this includes all variations you might see of reflux, silent reflux and colic) vary widely.

In fact, in taking a holistic approach, we look at over 80 different symptoms, behaviours and patterns of these in every child. And this is a part of the problem.

You see, reflux is not actually a disease, and this is why it does not have it’s own unique set of symptoms that present every time. Reflux itself is a symptom.

And it is by reframing it that we start to understand it much better, much quicker and we can take much stronger, swifter, action to resolve it.

If you feel that you baby is upset, unsettled, cries a lot, brings up feeds frequently, you may, or may not get a diagnosis of reflux from your health visitor, midwife or doctor.

There is no proper guidelines for “diagnosing” reflux. The recommendations referred to above (you can access the full document here) suggest using the symptoms listed in this document which are few in number and ignore much of what we really need to be looking for.

“Symptoms and signs that may be associated with gastro- oesophageal reflux disease in infants and children

  • Discomfort/irritability
  • Failure to Thrive
  • Feeding refusal
  • Dystonic neck posturing
  • (Sandifer syndrome)
  • Recurrent regurgitation with/
    without vomiting in the older child
  • Hematemesis
  • Dysphagia/odynophagia
  • Wheezing
  • Stridor
  • Cough
  • Hoarseness
  • Dental erosion
  • Anaemia
  • Esophagitis
  • Oesophageal Stricture
  • Barrett oesophagus
  • Apnoea spells
    Recurrent pneumonia associated with aspiration
  • Recurrent otitis media"

The guidelines also provide some Red Flag Symptoms that may not be related to reflux for practitioners to look out for a differential diagnosis.

However, if you compare the list of symptoms above to the list of symptoms and behaviours that we look at for a holistic understanding of what is going on for every child, you will see that there is a lot that is being ignored by the medical world. You can download this list of symptoms in our free symptoms tracker.

So then how is reflux officially diagnosed?

Well, there is no strict set of symptoms to allow for this to happen.

If a parent describes baby as upset a lot with a lot of vomiting and spit up, this can be enough for one doctor to diagnose reflux, while another in the very same practice might just say “that’s just spit up”.  

A parent might describe baby as being particularly unsettled all the time and never happy with some feeding troubles, and this might be enough for one doctor to diagnose reflux while another might simply say “all babies cry”.

And what are you to do when there is all this lack of clarity about it?

Trust yourself.

If you believe your baby is more unsettled than they should be, if you think they are telling you that they are uncomfortable or in pain, then this is enough to want to do something about it.

We don’t need to have a formal diagnosis from a doctor to take action.

Start with our symptoms tracker, if your baby has 3 or more symptoms or behaviours on this list consistently or regularly, and you feel they are more unsettled than they should be, then we can do something to support them to be more comfortable in their body.

They deserve to be comfortable.
You deserve to enjoy parenting.
And you don't need an 'official' diagnosis to achieve either of these things.

Áine x

Are you beyond ready to help your baby overcome reflux?! 

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The best place to start is always to pinpoint the symptoms your baby is experiencing. It's these symptoms which will lead you to the underlying causeaka. the real issue that needs resolving!

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