title: Managing gastroesophageal reflux symptoms in the very low-birth-weight infant postdischarge.
abstract: Gastroesophageal reflux and gastroesophageal reflux disease symptoms are common challenges for very low-birth-weight infants (<1500 g). These symptoms frequently result in feeding difficulties and family stress. Management of symptoms across healthcare disciplines may not be based on current evidence, and inconsistency can result in confusion for families and delayed interventions. The feeding relationship between infant and caregivers may be impaired when symptoms are persistent and poorly managed. An algorithm for managing gastroesophageal reflux-like symptoms in very low-birth-weight infants (from hospital discharge to 12 months corrected age) was developed through the formation of a multidisciplinary community of practice and critical appraisal of the literature. A case study demonstrates how the algorithm results in a consistent approach for identifying symptoms, applying appropriate management strategies, and facilitating appropriate timing of medical consultation. Application to managing gastroesophageal reflux symptoms in the neonatal intensive care unit will be briefly addressed.
authors.affiliation: Mount Royal University, School of Nursing and Midwifery, Calgary, Alberta (Ms Sherrow); Respiratory Home Care Clinic, Alberta Children's Hospital and Alberta Health Services, Calgary (Ms Dressler-Mund); Early Child Development Team, Child Development Centre, Alberta Health Services, Calgary (Ms Kowal); Perinatal Follow-up Clinic, Alberta Children's Hospital, Alberta Health Services, Calgary (Ms Dai); private practice and Alberta Health Services, Calgary (Ms Wilson); and Neonatal Transition Team, Postpartum Community Health Services, Alberta Health Services, Calgary, Canada (Ms Lasby).
authors.forename: Tammy
authors.initials: T
authors.lastname: Sherrow
authors.forename: Donna
authors.initials: D
authors.lastname: Dressler-Mund
authors.forename: Kelly
authors.initials: K
authors.lastname: Kowal
authors.forename: Susan
authors.initials: S
authors.lastname: Dai
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Wilson
authors.forename: Karen
authors.initials: K
authors.lastname: Lasby
mesh_terms: D000465:Algorithms; D001903:Bottle Feeding / Q000379:methods*; D001942:Breast Feeding / Q000379:methods*; D004509:Education, Nursing, Continuing; D019317:Evidence-Based Medicine; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D019982:Organizational Case Studies; D010287:Parent-Child Relations; D010351:Patient Discharge