Definition

• Pain or burning caused by irritation of the lower esophagus from stomach acid. The esophagus is the tube from mouth to stomach.
• Pain is located in the lower chest or upper belly
• Also, called acid indigestion

Health Information

Symptoms

• Burning pain behind the lower part of the breastbone or the upper stomach.
• Pain is worse with lying down.
• Can cause a sour (acid) taste in the mouth. Reflux most often follows large meals.

Causes

• Irritation of the lower esophagus by the reflux of stomach acid

Care Advice

1. Overview:
   • Belching is normal. So is some reflux of stomach contents when bending over.
   • Heartburn is less common, perhaps 5% of children.
   • It’s due to stomach acid going up into the esophagus.
   • Here is some care advice that should help.
2. Antacids:
   • Most often, heartburn is easily treated. Give 1 to 2 tablespoons (15-30 ml) of liquid antacid by mouth. You can use Mylanta or the store brand. No prescription is needed.
   • If you don’t have an antacid, use 2 to 3 ounces (60-90 ml) of milk.
   • For heartburn that keeps coming back, give an antacid 1 hour before meals. Also, give a dose at bedtime. Do this for a few days.
3. Acid Blocking Medicines:
   • Your doctor may suggest an acid blocking medicine. These drugs are called H2 blockers. No prescription is needed.
   • Examples are Zantac and Pepcid.
   • Give the medicine as directed.
   • Stay on it for at least 2 weeks.
4. Prevention of Heartburn:
   • Eat smaller meals. Large meals overfill the stomach.
   • Avoid bedtime snacks. (Reason: Your child will be lying down soon)
   • Do not eat foods that make heartburn worse. Examples are chocolate, fatty foods, spicy foods, sodas, and caffeine.
   • Do not bend over during the 3 hours after meals.
   • Do not wear tight clothing or belts around the waist.
   • Lose weight if this is a problem.
5. What to Expect:
   • Most often, heartburn goes away quickly with treatment.
   • Heartburn also tends to come back. So, preventive measures are important.

Call Your Doctor If

• Heartburn doesn’t improve after 2 days of treatment
• Heartburn doesn’t go away after 1 week of treatment
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

 #AAP