Literature review for - Flourish Paediatrics

Studies used to make evidence statements for gastroesophageal reflux (GOR) in infants
Reference Ewer et al. (1996) Heacock et al. (1992) Nelson et al (1997)
Type of study Case-series Non-randomized experimental trial Cross-sectional study
with concurrent controls
Level of evidence IV (aetiology) III-2 (intervention) IV (aetiology)
Definition of
breastfeeding
Poorly Defined Poorly defined Not defined
Intervention/
comparator
Gastric emptying time (range
15-114 minute)
Feed volume (range ≈30-60 ml)
Number of reflux episodes and
number of reflux episodes > 5
minutes during postprandial period
breastfeeding vs. formula feeding
Prevalence of GOR
N 19 preterm infants 74 infants. 104 approached 948 parents
Population/study
information
The study was carried out on the
Regional Neonatal Intensive Care
Unit at Birmingham Maternity
Hospital.
Gastric emptying was measured in
19 healthy preterm infants that were
receiving full enteral feeds via a
nasogastric tube. Median gestational
age= 32 weeks. No infant had
symptomatic reflux before the study.
Gastric emptying was measured
Study comprised of 32 breastfed and
32 formula fed infants delivered at
King George V public hospital in
NSW between 1989-90. Infants were
healthy term newborns aged between
2-8 days.
Infants were studied for 4 hours after
their milk feed in the morning. GOR
was recorded by a pH microelectrode
during the third and forth postprandial
hours.
In 1995 a questionnaire on GOR was
distributed to parents of healthy infants
13 months old or younger in 19 practices
in the Pediatric Practice Research Group
in Chicago.
Parents reported frequency of
regurgitation in their infants
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