Nonpharmacological management of gastroesophageal reflux in preterm infants.
Gastroesophageal reflux (GOR) is very common among preterm infants, due to several physiological mechanisms. Although GOR should not be usually considered a pathological condition, its therapeutic management still represents a controversial issue among neonatologists; pharmacological overtreatment, often unuseful and potentially harmful, is increasingly widespread. Hence, a stepwise approach, firstly promoting conservative strategies such as body positioning, milk thickening, or changes of feeding modalities, should be considered the most advisable choice in preterm infants with GOR. This review focuses on the conservative management of GOR in the preterm population, aiming to provide a complete overview, based on currently available evidence, on potential benefits and adverse effects of nonpharmacological measures. Nonpharmacological management of GOR might represent a useful tool for neonatologists to reduce the use of antireflux medications, which should be limited to selected cases of symptomatic babies.
Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, Via Massarenti 11, 40138 Bologna, Italy ; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Luigi
L
Corvaglia
Silvia
S
Martini
Arianna
A
Aceti
Santo
S
Arcuri
Roberto
R
Rossini
Giacomo
G
Faldella
D005247:Feeding Behavior; D005764:Gastroesophageal Reflux / Q000151:congenital* / Q000628:therapy*; D006801:Humans; D041943:Infant Formula; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D008895:Milk, Human / Q000737:chemistry; D041361:Pacifiers