Babies
Babies may see relief with smaller, more frequent feedings, more frequent burping during feedings, holding the baby in an upright position 30 minutes after feeding, keeping the babys head elevated while laying on the back, removing milk and soy from the mothers diet or feeding the baby milk protein-free formula. They may also be treated with medicines such as ranitidine or proton pump inhibitors. Proton pump inhibitors however have not been found to be effective in this population and there is a lack of evidence for safety. The role of an Occupational Therapist with an infant with GERD includes positioning during and after feeding. One technique used is called “the log roll technique” which is practiced when changing an infants clothing or diapers. Placing an infant on their back while having their legs lifted is not recommended since it causes the acid to flow back up the esophagus. Instead, the occupational therapist would suggest rolling the child on the side, keeping the shoulders and hips aligned to avoid acid rising up the babys esophagus. Another technique used is feeding the baby on their side with an upright position instead of lying flat on their back. The final positioning technique used for infants is to keep them on their tummy or upright for 20 minutes after feeding. Epidemiology
In Western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. For instance, an estimated 3.4 million to 6.8 million Canadians have GERD.
Treatment
Anasarca is a severe symptom, not a pathological process in and of itself; as such, the best treatment is to treat the underlying cause. However, there are a number of things that can be done to help get the fluid off as well as prevent further accumulation of fluid. Diuretics
One of the mainstays of any edema treatment, diuretics are a category of medications that help the body excrete fluid by altering the way in which the kidney processes urine. Loop diuretics
Thiazide diuretics
Thiazide-like diuretics
Potassium-sparing diuretics

Diet
The body more efficiently absorbs fluid from the gut and retains that fluid with the help of sodium and sugar. As such, decreasing salt and simple sugar intake will help prevent accumulation of fluid and potentiate the effect of any diuretics. Following a high protein diet will help provide ones body with the substrates necessary to produce albumin, the major protein in human plasma and the single most important molecule in maintaining the serum oncotic pressure. Fiber
Bulking fiber, both soluble and insoluble dietary fiber, absorb water throughout the GI tract. Viscous fiber can thicken the contents of the GI track and slow the absorption of other compounds (like simple sugars). References


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