A critical appraisal of current management practices for infant regurgitation--recommendations of a working party.
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 gastro-oesophageal 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. The updated recommendations reached by the working party on the management of infant regurgitation contain five phases: (1 A) parental reassurance; (1 B) milk-thickening agents; (2) prokinetics; (3) positional therapy as an adjuvant therapy; (4 A) H2-blockers; (4 B) proton pump inhibitors; (5) surgery.
Vandenplas
Y
Y
Academisch Zeckenhuis Kinderen, Vrije Universiteit Brussel, Brussels, Belgium.
Belli
D
D
Benhamou
P
P
Cadranel
S
S
Cezard
J P
JP
Cucchiara
S
S
Dupont
C
C
Faure
C
C
Gottrand
F
F
Hassall
E
E
Heymans
H
H
Kneepkens
C M
CM
Sandhu
B
B
D000863:Antacids / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D019090:Case Management / Q000592:standards*; D002986:Clinical Trials as Topic; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000628:therapy*; D006266:Health Education; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*; D016684:Prone Position; D012075:Remission, Spontaneous; D013398:Sudden Infant Death / Q000209:etiology; D016896:Treatment Outcome
D000863:Antacids; D000932:Antiemetics