Medical intervention in parent-reported infant gastro-oesophageal reflux: A population-based study.
OBJECTIVE
To report the cumulative incidence, health-seeking behaviour and medical intervention of infants with gastro-oesophageal reflux (GOR) in the first year of life.


METHODS
The HealthNuts study is a longitudinal, population-based study. At 12 months of age, infants underwent skin prick testing to food allergens, including cows milk. Parents completed a questionnaire on GOR symptoms, food allergy and treatments. Factors associated with seeking health care for infants with GOR were modelled using logistic regression.


RESULTS
Of 4674 infants, parents reported GOR in 1054 (23%; 95% confidence interval (CI) 21.4-23.8). Parents consulted a medical practitioner in 662 (64%) cases. Symptoms commenced in the first month in 411 (48%) and resolved within 6 months in 703 (75%) infants. Factors associated with doctor consultation for GOR were prematurity (adjusted odds ratio (aOR) 1.94; 95% CI 1.43-2.63) and family history of atopy (aOR 1.64; 95% CI 1.1-2.43). Eight per cent of infants (371/4674; 95% CI 7.2-8.7) received anti-reflux medication and 6% (296/4674; 95% CI 5.7-7.1) changed formula. Parents were more likely to seek treatment if they perceived their infant to be unsettled (aOR 2.55; 95% CI 1.26-5.17) and if the duration of GOR was prolonged (aOR 3.36 for symptoms >6 months; 95% CI 1.83-6.17).


CONCLUSIONS
In the first year of life, approximately 14% of the population seek medical advice for GOR symptoms. The use of anti-reflux medication in the general community remains high, despite the absence of evidence that it is appropriate or effective for uncomplicated GOR.
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, China.
Sun
S
Hua
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Rachel L
RL
Peters
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Katrina J
KJ
Allen
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.|School of Population Health, The University of Melbourne, Melbourne, Victoria, Australia.
Shyamali C
SC
Dharmage
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Mimi Lk
ML
Tang
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Melissa
M
Wake
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.|Monash School of Medicine, Monash University, Melbourne, Victoria, Australia.
Rebecca
R
Foskey
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Ralf G
RG
Heine
cows milk allergy; epidemiology; food allergy; health care utilisation; reflux; regurgitation