title: [Gastroesophageal reflux and sleep position of infants. A survey conducted in France by 493 pediatricians].
abstract: OBJECTIVE
  The supine sleeping position with the head higher than the legs has no impact on regurgitations in infants. Inclined ventral decubitus decreases regurgitations but is associated with an increased risk of sudden infant death syndrome (SIDS). The LUNE study aimed to evaluate the impact of regurgitations on the choice of sleeping position by pediatricians and parents.
  
  
  METHODS
  Cross-sectional case-control study (ratio 1:1) conducted in France in 2013. A representative sample of pediatricians recruited 3-week to 4-month-old breast- or formula-fed infants. Cases and controls were defined by the presence or absence of regurgitations. Collected data included Vandenplas codification for regurgitations (VD, range 0-6), associated symptoms, and variations in sleeping position since maternity hospital discharge.
  
  
  RESULTS
  A total of 1347 cases and 1346 controls were recruited by 493 pediatricians. Regurgitations were evaluated at VD1 (minor, 22 % of cases), VD2 (mild, 47 % of cases), or VD≥3 (moderate to severe, 31 % of cases). At the maternity hospital, the supine position was recommended to 96 % of parents for SIDS prevention. Since discharge, parents asked questions about the relationship between sleeping position and regurgitations (79 % of infants with GER versus 45 % of controls). The sleeping position was modified at least once since maternity discharge (42 % of infants with GER versus 35 % of controls). At inclusion, 86 % of infants with GER and 86 % of controls were sleeping on their back. Fifty-one percent of infants with GER and 28 % of controls slept in an inclined position. Pediatricians repeated the prescription of dorsal decubitus for 91 % of infants with GER and recommended an inclined position in 70 %.
  
  
  CONCLUSIONS
  Regurgitations had no impact on supine sleeping position. The inclined supine sleeping position was more frequent in infants with regurgitations with pediatricians' assent, which is not in agreement with evidence-based medicine.
authors.affiliation: Service de gastro-entérologie, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France. Electronic address: marc.bellaiche@aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Bellaïche
authors.affiliation: Unité d'explorations digestives pédiatriques, hôpital privé de la Seine-Saint-Denis, 7, avenue Henri-Barbusse, 93150 Le Blanc-Mesnil, France.
authors.forename: K
authors.initials: K
authors.lastname: Bargaoui
authors.affiliation: Centre de recherche clinique, centre de ressources biologiques, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France.
authors.forename: C
authors.initials: C
authors.lastname: Jung
authors.affiliation: Nutrition hygiène santé (NHS), 1-7, rue du Jura, BP 40528, 94633 Rungis cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Maigret
authors.affiliation: Soladis clinical studies, 84, boulevard du Général-Leclercq, 59100 Roubaix, France.
authors.forename: P
authors.initials: P
authors.lastname: Clerson
mesh_terms: D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012890:Sleep; D016683:Supine Position