Theresa M Shalaby1, Susan R Orenstein. 1. Pediatric Gastroesophageal Reflux Studies, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pennsylvania, USA. Theresa.Shalaby@chp.edu
Abstract
OBJECTIVES: To evaluate the efficacy of a specific protocol of conservative therapy for infant gastroesophageal reflux. STUDY DESIGN: Retrospective evaluation of the response to telephone teaching of conservative therapy by a single instructor as part of the screening process for a pharmacotherapy study of infantile reflux. Feeding modifications included the use of a protein-hydrolysate formula thickened with one tablespoon of dry rice cereal per ounce, at restricted volumes. Positioning changes included avoidance of seated and supine positions. Elimination of all tobacco smoke exposure was advised. SETTING: Single-center, outpatient. SUBJECTS: 394 infants <12 months old. EFFICACY: the percentage responding to conservative therapy instruction. Factors possibly predicting success for isolated conservative therapy instruction: evaluated as explanatory variables by chi(2) analysis; significance at P <.05. RESULTS: Ninety-six infants (24%) had sufficient symptom improvement and no additional intervention was required. Infants with isolated vomiting or irritability were more likely to respond than infants with both or other symptoms (P <.001). Neither formula type fed nor use of pharmacotherapy at referral were significant in determining response to conservative therapy. CONCLUSIONS: As many as 24% of infants with gastroesophageal reflux disease may respond to conservative therapy instruction provided by telephone. Benefits include savings of cost, time, and drug exposure of infants.
OBJECTIVES: To evaluate the efficacy of a specific protocol of conservative therapy for infantgastroesophageal reflux. STUDY DESIGN: Retrospective evaluation of the response to telephone teaching of conservative therapy by a single instructor as part of the screening process for a pharmacotherapy study of infantile reflux. Feeding modifications included the use of a protein-hydrolysate formula thickened with one tablespoon of dry rice cereal per ounce, at restricted volumes. Positioning changes included avoidance of seated and supine positions. Elimination of all tobacco smoke exposure was advised. SETTING: Single-center, outpatient. SUBJECTS: 394 infants <12 months old. EFFICACY: the percentage responding to conservative therapy instruction. Factors possibly predicting success for isolated conservative therapy instruction: evaluated as explanatory variables by chi(2) analysis; significance at P <.05. RESULTS: Ninety-six infants (24%) had sufficient symptom improvement and no additional intervention was required. Infants with isolated vomiting or irritability were more likely to respond than infants with both or other symptoms (P <.001). Neither formula type fed nor use of pharmacotherapy at referral were significant in determining response to conservative therapy. CONCLUSIONS: As many as 24% of infants with gastroesophageal reflux disease may respond to conservative therapy instruction provided by telephone. Benefits include savings of cost, time, and drug exposure of infants.
Authors: Ciro Esposito; Agnese Roberti; Francesco Turrà; Maria Escolino; Mariapina Cerulo; Alessandro Settimi; Alessandra Farina; Pietro Vecchio; Antonio Di Mezza Journal: Pediatric Health Med Ther Date: 2015-01-23