(COLUMBUS, Ohio) – In a new study published in The Journal of Pediatrics, researchers in the Abigail Wexner Research Institute at Nationwide Children’s Hospital have found that high-risk infants who express irritability and arching of their backs likely are not suffering from gastroesophageal reflux disease (GERD).
GERD is a disease in which the lower esophageal sphincter does not close or opens at the wrong time. As a result, food and stomach acid can come back up and may be vomited, which can cause pain from irritation in a baby’s esophagus. GERD can cause difficulty in eating or refusal to eat, along with crankiness during feeding. One visible behavior that parents and caregivers often attribute to GERD is arching of the back, potentially in response to the burning sensation in the esophagus.
In this study that observed more than 500 infants in the neonatal intensive care unit (NICU) being evaluated for GERD, researchers found that less than 10% of arching/irritability events occurred after acid reflux, and when comparing acid GERD biomarkers in infants with frequent and infrequent arching and irritability, no association was found. In fact, 92% of arching/irritability events were determined to be from other internal and external reasons.
“No caregiver wants to hear that they simply have a fussy infant, but it is important and positive to note that not all arching or irritability is because of GERD,” said Sudarshan Jadcherla, MD, lead author of the study, neonatologist and principal investigator at the Center for Perinatal Research at Nationwide Children’s. “This knowledge can help lessen the unnecessary prescription of GERD-related medications to these infants, and increase the consideration of other factors contributing to arching and irritability.”
Researchers also noted that preterm birth increased the likelihood of frequent arching and irritability, which could be due to neurologic impairment or chronic lung disease seen in prematurity. Reassuringly, most infants in the study were able to feed orally at discharge, meaning caregivers may experience less pressure to have GERD-related medications or lifestyle changes prescribed.
“Parents know their children best, and if there are ever any concerns with a baby’s development, temperament or behavior, families should connect with their child’s pediatrician to explore solutions,” said Dr. Jadcherla, who is also medical director of the Neonatal and Infant Feeding Disorders Program at Nationwide Children’s.
About The Abigail Wexner Research Institute at Nationwide Children's Hospital
Named to the Top 10 Honor Roll on U.S. News & World Report’s 2023-24 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit free-standing pediatric health care systems providing unique expertise in pediatric population health, behavioral health, genomics and health equity as the next frontiers in pediatric medicine, leading to best outcomes for the health of the whole child. Integrated clinical and research programs are part of what allows Nationwide Children’s to advance its unique model of care. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s faculty train the next generation of pediatricians, scientists and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded free-standing pediatric research facilities in the U.S., supporting basic, clinical, translational, behavioral and population health research. The AWRI is comprised of multidisciplinary Centers of Emphasis paired with advanced infrastructure supporting capabilities such as technology commercialization for discoveries; gene- and cell-based therapies; and genome sequencing and analysis. More information is available at NationwideChildrens.org/Research.