Impact of Feeding Strategies on the Frequency and Clearance of Acid and Nonacid Gastroesophageal Reflux Events in Dysphagic Neonates
Journal of Parenteral and Enteral Nutrition, 06/26/2012
Jadcherla SR et al. – Prolonged feeding durations and slower flow rates are associated with decreased frequency of gastroesophageal reflux (GER). Modification of feeding duration and flow rate can be a useful adjunct to ameliorate GER in dysphagic neonates.Methods
- Symptomatic dysphagic neonates (n=35) underwent evaluation for suspected GER using pH-impedance methods.
- The proportions of acid and nonacid GER were different during the first, second, and third postprandial hours (P<.0001).
- Prolonged feeding duration was significantly associated with decreased total, nonacid GER and BCT (P<.03).
- Significant positive correlations (P<.05) were detected between feeding flow rate vs frequency of total, nonacid GER and BCT.
- Significant positive correlation (P=.002) was noted between feeding volume and BCT.
- BCT decreased with each hourly interval (analysis of variance [ANOVA] P<.05); however, ACT increased with each hourly interval (ANOVA P=.05).
- Comparison between BCT and ACT at each postprandial hour is remarkable for longer ACT during the second and third hours after the initiation of feed (P≤.001).
- No significant correlation was noted between the milk types (breast milk or formula) or caloric density with regard to the GER characteristics.
- Oral-fed infants had more GER events than gavage-fed infants.