A critical appraisal of current management practices for infant regurgitation : recommendations of a working party

• Published in: European journal of pediatrics Vol. 156; no. 5; pp. 343 - 357
• Main Authors: VANDENPLAS, Y, BELLI, D, HEYMANS, H, KNEEPKENS, C. M. F, SANDHU, B, BENHAMOU, P, CADRANEL, S, CEZARD, J. P, CUCCHIARA, S, DUPONT, C, FAURE, C, GOTTRAND, F, HASSALL, E
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.05.1997; Berlin Springer Nature B.V
• Subjects: Antacids - therapeutic use; Antiemetics - therapeutic use; Babies; Biological and medical sciences; Case Management - standards; Clinical Trials as Topic; Content analysis; Epidemiology; Failure to thrive; Family physicians; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - physiopathology; Gastroesophageal Reflux - therapy; Health Education; Humans; Infant; Infant Food - standards; Medical sciences; Other diseases. Semiology; Practice Guidelines as Topic - standards; Primary care; Prone Position; Remission, Spontaneous; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Sudden Infant Death - etiology; Treatment Outcome; Vomiting; Netherlands; Belgium; France; Paris France; Human; Gastroesophageal reflux; Dietary allowance; Chemotherapy; Clinical management; Treatment; Esophageal disease; Regurgitation; Digestive diseases; Infant; Review
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s004310050613

Regurgitation is a common manifestation in infants below the age of 1 year and a frequent reason of counselling of general practitioners and paediatricians. Current management starts with postural and dietary measures, followed by antacids and prokinetics. Recent issues such as an increased risk of sudden infant death in the prone sleeping position and persistent occult gastro-oesophageal reflux in a subset of infants receiving milk thickeners or thickened "anti-regurgitation formula" challenge the established approach. Therefore, the clinical practices for management of infant regurgitation have been critically evaluated with respect to their efficacy, safety and practical implications. The updated recommendations reached by the working party on the management of infant regurgitation contain five phases: (1 A) parental reassurance; (1 B) milk-thickening agents; (2) prokinetics; (3) positional therapy as an adjuvant therapy; (4 A) H2-blockers; (4 B) proton pump inhibitors; (5) surgery.