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INFANT REFLUX DIAGNOSING AID

If you believe your baby is suffering from infant reflux and are having a difficult time getting your doctor to listen to you or confirm that diagnosis and help with medication, print and fill out the following list of symptoms for your next visit.  Remember you are your child's best advocate, the child's doctor will rely on you for an accurate and thorough description of your child's symptoms.  Remember, be assertive, but not aggressive.

This tool can also be used to determine success or failure of treatment methods as they are introduced, just date it before hand, mark the treatment and date started and after a week or two compare the results with the pre-treatment form.

Take this, along with the infant reflux impact survey with you to your next doctor's appointment.

 

Symptoms

Frequently

Occasionally

Never

Excessive crying or colic like behavior

      

Irritability or pain

      

Poor sleep and frequent waking

      

Neck and back arching, particularly during and after eating

      

Frequent spitting and / or throwing up

      

Wet burps and / or frequent hiccups

      

Ear, sinus or respiratory infections

      

Refusing food or accepting only a few bites despite being hungry

      

Food/oral aversions

     

Swallowing problems, gagging, choking

     

Chronic hoarse voice

     

Frequent red, sore throat without infection present

      

Apnea

     

Gagging themselves with their fingers or fist (sign of esophagitis)

     

Poor weight gain, weight loss, failure to thrive

      

Respiratory problems—pneumonia, bronchitis, wheezing, asthma, night-time cough, aspiration

      

Erosion of dental enamel

     

Neck arching (Sandifer's Syndrome)

     

Bad breath

      

I believe my child is in pain

      

*Disclaimer: The information available on this website should not be used as a substitute for professional medical care for the prevention, diagnosis, or treatment of your child's reflux. Please consult with your child's doctor or pharmacist before trying any medication (prescription or OTC) or following any treatment plan mentioned. This information is provided only to help you be as informed as possible about your child's condition.

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