Lack of efficacy of thickened feeding as treatment for gastroesophageal reflux

Bailey, David J.; Andres, Joel M.; Danek, Gale; Piñeiro-Carrero, V

doi:10.1016/s0022-3476(87)80151-8

Cited by 87 publications

(43 citation statements)

References 6 publications

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“…18 Meal thickening agents do not improve reflux index. 19,20 However, the use of thickened feeds has been shown to decrease several of the symptoms associated with GERD. 21 The addition of rice cereal as the thickening agent, however, has some disadvantages: it increases caloric density, and therefore, energy intake leading to increased weight gain and contributing to obesity.…”

Section: Treatment Optionsmentioning

confidence: 99%

GERD or not GERD: the fussy infant

Bhatia

Parish

2009

J Perinatol

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Section: Treatment Optionsmentioning

confidence: 99%

GERD or not GERD: the fussy infant

Bhatia

Parish

2009

J Perinatol

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“…Milk thickeners have been reported to reduce regurgitation in infants [4,92,99,127,128,133] and to improve sleep (possibly due to an improved satiety related to the higher caloric intake in the case of rice-thickened formula) [92]. However, their effects on the oesophageal acid exposure are inconsistent, as shown by pH monitoring [4,99,127,128,133] and scintigraphy [92] ( Table 1).…”

Section: Dietary Advicementioning

confidence: 99%

“…However, their effects on the oesophageal acid exposure are inconsistent, as shown by pH monitoring [4,99,127,128,133] and scintigraphy [92] ( Table 1). The number of reflux episodes may increase or decrease [99], the oesophageal acid exposure increase depending on the baby's position [4]. The duration of the long-lasting reflux episodes has been reported to significantly increase [127,128] or remain unchanged [133].…”

Section: Dietary Advicementioning

confidence: 99%

“…These recommendations were published prior to, or simultaneously with 'anti-prone-sleeping position' campaigns conducted and supported by governments and medical societies. Moreover, some of the recommendations of 1993 can be challenged upon critical analysis of the efficacy data, such as the effect of milk thickeners on pH-metric or scintigraphic parameters [4,92,99,127,128,133].…”

Section: Introductionmentioning

confidence: 99%

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A critical appraisal of current management practices for infant regurgitation - recommendations of a working party

Vandenplas

Belli²,

Benhamou

et al. 1997

European Journal of Pediatrics

126

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A critical appraisal of current management practices for infant regurgitation: recommendations of a working party Vandenplas, Y.; Belli, D.; Benhamou, P.; Cadramel, S.; Cezard, J.P.; Cucchiara, S.; Dupont, C.; Faure, C.; Gottrand, F.; Hassall, E.; Heymans, H.S.A.; Kneepkens, C.M.F.; Sandhu, B. Published in:European Journal of Pediatrics DOI:10.1007/s004310050613Link to publication Citation for published version (APA):Vandenplas, Y., Belli, D., Benhamou, P., Cadramel, S., Cezard, J. P., Cucchiara, S., ... Sandhu, B. (1997). A critical appraisal of current management practices for infant regurgitation: recommendations of a working party. European Journal of Pediatrics, 156, 343-357. DOI: 10.1007/s004310050613 General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Abstract Regurgitation is a common manifestation in infants below the age of 1 year and a frequent reason of counselling of general practitioners and paediatricians. Current management starts with postural and dietary measures, followed by antacids and prokinetics. Recent issues such as an increased risk of sudden infant death in the prone sleeping position and persistent occult gastrooesophageal reflux in a subset of infants receiving milk thickeners or thickened ''anti-regurgitation formula'' challenge the established approach. Therefore, the clinical practices for management of infant regurgitation have been critically evaluated with respect to their efficacy, safety and practical implications.

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“…64 Thickened feedings may not decrease the frequency of GER, but may decrease the episodes of frank vomiting. 65,66 Unfortunately, the option of thickened feedings is unavailable to breastfed infants unless thickened formula is offered. 6…”

Section: Nonpharmacologic Managementmentioning

confidence: 99%

Discerning Differences

Henry

2004

Advances in Neonatal Care

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Gastroesophageal reflux (GER) is a frequently encountered problem in infancy; it commonly resolves spontaneously by 12 months of age. Caregivers are challenged to discriminate between physiologic GER and the much less common and more serious condition of pathologic gastroesophageal reflux disease (GERD). Pathologic GERD may require more extensive clinical evaluation and necessitate treatment. GERD may be primary or secondary; secondary GERD is associated with a number of genetic syndromes, chromosomal abnormalities, birth defects, or a host of neurologic conditions frequently seen in the newborn intensive care unit. This article reviews the unique anatomic, physiologic, developmental, and nutritional vulnerabilities of infants that make them susceptible to GER and GERD. The North American Society of Pediatric Gastroenterology and Nutrition have recently developed a comprehensive evidence-based clinical practice guideline that structures the diagnostic approach and treatment option in infants with suspected and confirmed GERD. These guidelines provide clear definitions of GER and GERD to aid the clinician in distinguishing between the 2 conditions. They emphasize the use of history and physical examination and discuss the indications for the use of other diagnostic procedures, such as upper gastrointestinal studies, nuclear medicine scintiscan, esophagogastroduodenoscopy with biopsy, and esophageal pH probe monitoring. Management of GERD begins with a nonpharmacologic approach; the emphasis is on positioning, a trial of a hypoallergenic formula, and thickening of feedings. When these measures fail to control symptoms, a trial of either histamine(2) antagonists or a proton pump inhibitor may be indicated. Finally, surgical treatment may be needed if all other management measures fail. New sleep recommendations for infants with GERD are now consistent with the American Academy of Pediatrics' standard recommendations. Prone sleep positioning is only considered in unusual cases, where the risk of death and complications from GERD outweighs the potential increased risk of sudden infant death syndrome (SIDS). The nursing care of infants with GER and GERD, as well as relevant issues for parent education and support, are reviewed and are essential elements in managing this common condition.

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Lack of efficacy of thickened feeding as treatment for gastroesophageal reflux

Cited by 87 publications

References 6 publications

GERD or not GERD: the fussy infant

GERD or not GERD: the fussy infant

A critical appraisal of current management practices for infant regurgitation - recommendations of a working party

Discerning Differences

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