How is gastroesophageal reflux a problem for babies with heart defects?

Gastroesophageal reflux (GERD) can be a problem for babies with congenital heart disease, which is heart disease that is present at birth. Reflux happens when stomach contents move backward into the esophagus and sometimes upward into the mouth. Infants with reflux can spit up or even vomit after feedings. This can cause two problems:
  • First, the spitting up or vomiting is a loss of calories that reduces their overall intake. This can lead to your child not taking in enough calories to gain weight. 
  • Second, when stomach contents move backward up into the esophagus, there is a chance they could go back down the wrong way into the lungs. This is called aspiration. Aspiration can cause damage to the lung tissue and/or lung infections like pneumonia. This is a serious complication for infants with normal hearts, but it is even more serious for infants with congenital heart disease. Their lungs and heart have to work so hard to get oxygen into the blood and out to the body that the smallest amount of damage can cause significant problems with getting oxygen into the blood. This often can be managed by surgery. 
One procedure to correct GERD is a Nissen fundoplication. In this procedure, a surgeon wraps part of the stomach around the lower part of the esophagus to tighten up the area, making it harder for stomach contents to move backward. It is not uncommon that during this same procedure a gastrostomy tube (feeding tube, also called a G-tube) would be placed into the stomach directly, especially for patients who are at high risk for aspirating when feeding by mouth. A G-tube allows for formula and/or breast milk to go directly into the stomach, thus reducing the risk of aspiration and decreasing the amount of energy the infant burns during feedings.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.