Maturation of Motor Function in the Preterm Infant and Gastroesophageal Reflux

Hibbs, Anna Maria

doi:10.1016/b978-1-4377-2603-9.00002-8

Cited by 1 publication

(3 citation statements)

References 97 publications

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“…The LES relaxation in TLESRs is typically of longer duration than those observed following meal propagation after swallowing, and therefore may allow a proportionately larger refluxed volume [5,[15][16][17]. While reflux in infants tends to be less acidic than adults, resulting presumably at least in part from the buffering capacity of milk [19], infants with reportedly symptomatic reflux tend to have more acidic refluxate than those with proven TLESRs without signs of GERD [16][17][18]20].…”

Section: Gastrointestinal Tract Developmentmentioning

confidence: 99%

“…However, it cannot assess the frequency of reflux events. A nuclear medicine scintigraphic study ("milk scan"), in which a radionuclide tracer is added to an infant's milk, can reveal whether the milk is refluxed and/or aspirated [1,5,19].…”

Section: Diagnosing Gerdmentioning

confidence: 99%

“…Signs associated with GERD in infants have included apnea, airway irritation, worsening of lung disease, poor growth, and apparent pain or irritability [1,2,6,7,19,21]. Despite this, the evidence to support reflux as a cause of these findings is slim, and agreement is poor among subspecialists who care for infants regarding which signs are attributable to GE reflux, as well as whether or how it should be treated [22].…”

Section: Gastroesophageal Reflux Disease (Gerd)mentioning

confidence: 99%

See 2 more Smart Citations

Gastro-Esophageal Reflux in the Newborn: Pathologic Event or Does Spit Happen?

Stepanovich¹,

Donn²

2021

OBM HG

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Infants admitted to Neonatal Intensive Care Units (NICUs) are among the most vulnerable patients in medicine and are at risk for a variety of morbidities, many of which require pharmacologic therapy. Gastroesophageal Reflux Disease (GERD) is a common diagnosis in the NICU patient population and may or may not represent a truly pathologic process. Regardless, pharmacologic therapy is provided to many infants, who are already exposed to an inordinate number of pharmacologic agents, of which most are off label and have an inadequate evidence base to establish either efficacy or safety. Furthermore, as infancy represents a time of dramatic growth and development, many conditions resolve over time, making treatment unnecessary and potentially dangerous. Infants with GERD, especially those born prematurely, exemplify the complexity of attempting pharmacologic therapy with unproven consistent benefit versus “watching and waiting.” The following will present physiology of GERD, gastrointestinal tract anatomy and development as well as options for pharmacologic and non-pharmacologic therapies.

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