Although the significance of gastroesophageal reflux (GER) in newborn discomfort is debatable, acid inhibitors are frequently administered empirically. In this study, researchers looked at the relationship between distress as measured by the Face, Legs, Activity, Cry, Consolability (FLACC) scale and GER in newborns. Multiple intraluminal impedance-pH (MII-pH) monitoring tracings from babies with persistent fussiness or distress were examined. Parents used the FLACC scale to evaluate symptoms that occurred throughout the investigation, which were then categorized as “distress” events. They enlisted the help of 62 children. During MII-pH, 452 episodes of distress were recorded: 217 of which were temporally linked with GER and 235 of which were not, with no change in the median FLACC score between the two groups. Infants with an abnormal acid exposure index showed a substantially lower FLACC than those with an acid reflux index of 7%. GER occurred considerably more frequently before, than concurrently or after, an episode of distress when it was linked with symptoms. FLACC scores were unrelated to age, proximal extension, or length of GER. Distress episodes linked with nonacid reflux had a much greater FLACC than those with acid content. In newborns, bouts of distress do not have a substantial relationship with GER.

There was no difference in baby suffering between proximal and distal GER. Non-acid GER is believed to be at least as painful as acid GER. The findings emphasize the need of avoiding starting acid inhibitors in babies who are distressed until a definite link with acid GER is shown.

Reference: https://journals.lww.com/jpgn/Abstract/2020/10000/Distress_in_Infants_and_Young_Children__Don_t.10.aspx