Efficacy of telephone teaching of conservative therapy for infants with symptomatic gastroesophageal reflux referred by pediatricians to pediatric gastroenterologists.
OBJECTIVE
To evaluate the efficacy of a specific protocol of conservative therapy for infant gastroesophageal reflux.


METHODS
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.


METHODS
Single-center, outpatient.


METHODS
394 infants <12 months old.


METHODS



RESULTS
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.
Shalaby
Theresa M
TM
Pediatric Gastroesophageal Reflux Studies, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pennsylvania, USA. Theresa.Shalaby@chp.edu
Orenstein
Susan R
SR
D005248:Feeding Methods; D005260:Female; D005762:Gastroenterology; D005764:Gastroesophageal Reflux / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods; D011187:Posture; D012017:Referral and Consultation; D012189:Retrospective Studies; D013689:Telephone; D014028:Tobacco Smoke Pollution / Q000517:prevention & control
D014028:Tobacco Smoke Pollution