Reflux Incidence among Exclusively Breast Milk Fed Infants: Differences of Feeding at Breast versus Pumped Milk

Yourkavitch, Jennifer; Zadrozny, Sabrina; Flax, Valerie L.

doi:10.3390/children3040018

Cited by 9 publications

(5 citation statements)

References 38 publications

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“…Results on the influence of mode of feeding on GERD symptom prevalence in infants were conflicting, with some studies reporting no influence, and others demonstrating that breast‐fed infants are less likely to experience regurgitation suggesting that direct breast‐feeding is a protective factor against reflux (15,20). A recent study examining the monthly incidence of GERD in exclusively breast milk fed infants from ages 2 to 6 months failed to show an association between feeding mode and reflux incidence, but this analysis was limited by a small number of reported GERD cases (42). Based on expert opinion, current guidelines recommend to encourage breast‐feeding in infants with physiological GER, but indicate that for infants with significant complaints to add thickeners to pumped breast milk (43).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children

Singendonk

Goudswaard

Langendam

et al. 2019

J. pediatr. gastroenterol. nutr.

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Objectives: Gastroesophageal reflux disease (GERD) is defined as gastroesophageal reflux causing troublesome symptoms or complications. In this study we reviewed the literature regarding the prevalence of GERD symptoms in infants and children. Methods: Databases of PubMed, EMBASE, and Cochrane were systematically searched from inception to June 26, 2018. English-written studies based on birth cohort, school-based, or general population samples of ≥50 children aged 0 to 21 years were included. Convenience samples were excluded. Results: In total, 3581 unique studies were found, of which 25 studies (11 in infants and 14 in children) were included with data on the prevalence of GERD symptoms comprising a total population of 487,969 children. In infants (0–18 months), GERD symptoms are present in more than a quarter of infants on a daily basis and show a steady decline in frequency with almost complete disappearance of symptoms at the age of 12 months. In children older than 18 months, GERD symptoms show large variation in prevalence between studies (range 0%-38% of study population) and overall, are present in >10% and in 25% on respectively a weekly and monthly basis. Of the risk factors assessed, higher body mass index and the use of alcohol and tobacco were associated with higher GERD symptom prevalence. Conclusions: This systematic review demonstrates that the reported prevalence of GERD symptoms varies considerably, depending on method of data collection and criteria used to define symptoms. Nevertheless, the high reported prevalence rates support better investment of resources and educational campaigns focused on prevention.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children

Singendonk

Goudswaard

Langendam

et al. 2019

J. pediatr. gastroenterol. nutr.

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“…This might illustrate why formula-fed neonates have a higher proclivity for regurgitation. There is evidence that breastfed infants have different feeding patterns that are associated with reduced re ux due to self-regulation of milk consumption, resulting in increased frequency and decreased volume of feedings [31] . Furthermore, breastfed babies have quick stomach emptying.…”

Section: Discussionmentioning

confidence: 99%

Neonatal risk factors for functional gastrointestinal disorders in preterm infants in the first year of life

Jiang

Yang

et al. 2022

Preprint

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Objective: An assessment of functional gastrointestinal disorders (FGIDs) in premature infants in their first year of life and neonatal factors influencing the progression of FGIDs is conducted in this research. Methods: Subjects selected for the retrospective study involved preterm infants being hospitalized in the neonatal department of Northern Jiangsu People’s Hospital from September 2018 to September 2021. Data on neonatal risk factors such as gestational age, gender, birth weight, mode of delivery, feeding pattern, antibiotic administration and addition of probiotics, duration of hospitalization, maternal history of smoking, and mental condition, were all collected and analyzed. FGIDs were diagnosed as per Rome IV criteria and a multivariate logistic regression model has been applied for determining factors linked to it. Results: This study included 988 preterm infants, with 725 (73.4%) having at least one FGID, 449 (45.4%) having infant colic, 411 (41.6%) having infant regurgitation, 237 (24.0%) having infant dyschezia, 190 (19.2%) having functional constipation, and 34 (3.4%) having functional diarrhea throughout the first year of life. There was no evidence identified for infant rumination syndrome and recurrent vomiting syndrome. In total, 263 infants (26.6%) without FGID symptoms were included in the control group. Infant colic and infant regurgitation were found as the most prevalent FGIDs. Further, a higher prevalence of FGIDs was observed in preterm infants with infant colic as well as infant regurgitation in particular as being characterized by a low gestational age (<32w), low birth weight (<1.5kg), cesarean section, formula feeding, neonatal antibiotics use, hospitalization longer than 7 days, and maternal history of smoking. It was found from association analyses that infants exclusively breastfed in their first month of life were at lower risk for regurgitation than those in the control group. Moreover, a significantly low occurrence of functional constipation was found in infants being subjected to probiotics treatment than in the control. Conclusion: Therefore, unnecessary antibiotic use in the neonatal period, cesarean delivery, passive smoking, lack of breastfeeding, along with inappropriate probiotics usage are major risk factors for FGIDs, and their systematic control may be effective in reducing the susceptibility to and prevalence of FGIDs in preterm infants in the first year of life.

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“…Among diet modifications, the utility of GERD recommendations, such as thickening feeds or avoiding cow’s milk protein, remains undemonstrated in P-LPR regarding the lack of studies including infants or children with a positive diagnostic at the HEMII-pH. Similar observations may be made regarding the influence of type of milk on the occurrence of pharyngeal reflux events, because previous studies included GERD patients [ 95 , 96 , 97 ]. Smaller and frequent meals as well as sleep positioning (elevating the head of the bed) may provide benefit to infants with GERD and ‘reflux extension’ into the upper aerodigestive tract [ 6 , 98 ], but the utility of these approaches is still not demonstrated in children with only P-LPR [ 4 ].…”

Section: Therapeutic Strategiesmentioning

confidence: 98%

Pediatric Laryngopharyngeal Reflux: An Evidence-Based Review

Lechien

2023

Children

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Purpose: Pediatric laryngopharyngeal reflux (P-LPR) is associated with the development of common otolaryngological symptoms and findings. In the present study, the findings about epidemiology, clinical presentation, diagnostic and therapeutic outcomes of pediatric population were reviewed. Methods: A PubMed, Cochrane Library, and Scopus literature search was conducted about evidence-based findings in epidemiology, clinical presentation, diagnostic and therapeutic outcomes of P-LPR. Findings: The prevalence of LPR remains unknown in infant and child populations. The clinical presentation depends on age. Infants with LPR symptoms commonly have both gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux and related digestive, respiratory and ear, nose and throat symptoms. The GERD prevalence appears to decrease over the growth, and the clinical picture is increasingly associated with LPR symptoms and findings without GERD. The prevalence of LPR and proximal acid and nonacid esophageal reflux events may be high in some prevalent otolaryngological conditions (chronic otitis media, laryngolomalacia and apnea). However, the lack of use of hypopharyngeal–esophageal multichannel intraluminal impedance pH monitoring (HEMII-pH) limits the establishment of etiological associations. Proton pump inhibitors are less effective in P-LPR patients compared to GERD populations, which may be related to the high prevalence of weakly or nonacid reflux events. Conclusions: Many gray areas persist in P-LPR and should be not resolved without the establishment of diagnostic criteria (guidelines) based on HEMII-pH. The unavailability of HEMII-pH and the poor acid-suppressive therapeutic response are all issues requiring future investigations. Future controlled studies using HEMII-pH and enzyme measurements in ear, nose or throat fluids may clarify the epidemiology of P-LPR according to age and its association with many otolaryngological conditions.

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Reflux Incidence among Exclusively Breast Milk Fed Infants: Differences of Feeding at Breast versus Pumped Milk

Cited by 9 publications

References 38 publications

Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children

Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children

Neonatal risk factors for functional gastrointestinal disorders in preterm infants in the first year of life

Pediatric Laryngopharyngeal Reflux: An Evidence-Based Review

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