Starch thickening of human milk is ineffective in reducing the gastroesophageal reflux in preterm infants: A crossover study using intraluminal impedance

2006 ◽  
Vol 148 (2) ◽  
pp. 265-268 ◽  
Author(s):  
Luigi Corvaglia ◽  
Marianna Ferlini ◽  
Raffaella Rotatori ◽  
Vittoria Paoletti ◽  
Rosina Alessandroni ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Human Milk ◽  
Crossover Study ◽  
Preterm Infants ◽  
Intraluminal Impedance

Protein Content and Fortification of Human Milk Influence Gastroesophageal Reflux in Preterm Infants

2009 ◽  
Vol 49 (5) ◽  
pp. 613-618 ◽  
Author(s):  
Arianna Aceti ◽  
Luigi Corvaglia ◽  
Vittoria Paoletti ◽  
Elisa Mariani ◽  
Gina Ancora ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Human Milk ◽  
Protein Content ◽  
Preterm Infants

Nasogastric Feeding Tubes May Not Contribute to Gastroesophageal Reflux in Preterm Infants

2017 ◽  
Vol 35 (07) ◽  
pp. 643-647 ◽  
Author(s):  
Swati Murthy ◽  
Apryle Funderburk ◽  
Sheeja Abraham ◽  
Michele Epstein ◽  
Joan DiPalma ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Preterm Infants ◽  
Ph Monitoring ◽  
Feeding Tube ◽  
Acid Exposure ◽  
Total Fluid Intake ◽  
Nasogastric Feeding ◽  
Intraluminal Impedance ◽  
Significant Difference ◽  
Acid Exposure Time

Objective The objective was to determine if the presence of a nasogastric (NG) feeding tube is associated with increased gastroesophageal reflux (GER) and acid exposure in preterm infants. Study Design This is a retrospective study on preterm infants [gestational age (GA) <37 weeks] who were evaluated by multichannel intraluminal impedance and pH monitoring (MII-pH) between October 2009 and March 2016. Infants were divided into two groups, NG tube present and no feeding tube. GER events per hour and the percent of time with pH <4 during a 24-hour period were then compared. Results Eighty-three infants were included, 41 had an NG tube present and 42 did not. The group without an NG tube had significantly more reflux events per hour (2.3 ± 2.9 vs. 1.3 ± 0.8, p < 0.05) even after adjusting for differences in birth weight, GA, corrected GA, and total fluid intake. There was no significant difference in acidic events per hour and acid exposure time between the two groups. Conclusion The presence of a 5-French NG tube is not associated with an increase in GER or acid exposure in preterm infants. In fact, it appears that infants fed through an NG tube have fewer episodes of GER.

scholarly journals Prevalence and Risk Factors for Gastroesophageal Reflux in Symptomatic Very Preterm Neonates

2020 ◽  
Author(s):  
Yu Hu ◽  
Jian-Hua Fu ◽  
Shu-Cheng Zhang
Keyword(s):  
Risk Factors ◽  
Gastroesophageal Reflux ◽  
Confidence Interval ◽  
Preterm Infants ◽  
Odds Ratio ◽  
Preterm Neonates ◽  
Very Preterm ◽  
Intraluminal Impedance ◽  
Immature Development ◽  
Impedance Monitoring

Abstract Background Because of immature development, preterm infants are prone to respiratory and digestive symptoms of dyspnea, vomiting, and aspiration pneumonia. These symptoms are often observed in infants with gastroesophageal reflux (GER). However, the relationship between GER and these symptoms remain unclear.Methods A cohort of 61 preterm infants born at 32 weeks of gestation or earlier with respiratory or digestive symptoms were retrospectively reviewed. All the preterm infants underwent 24-hour pH-multichannel intraluminal impedance monitoring. Clinical data were analyzed using logistic regression analyses.Results Among the 61 symptomatic preterm infants, 34 were positive for pathologic GER with a prevalence of 55.7%. The GER associated symptoms included apnea (42.6%), cyanosis (19.7%), vomiting (14.8%), pneumonia (9.8%), and poor weight gain (13.1%). These respiratory and digestive symptoms were more frequent in infants with pathologic GER than in those without. (p<0.05) The risk factors for GER included severe BPD (odds ratio [OR], 6.890; 95% confidence interval [CI], 1.125-42.209). Probiotics and delayed full oral feeds reduced the risk of GER (odds ratio [OR], 0.642; 95% confidence interval [CI], 0.457-0.901, p<0.05; OR, 0.234, 95% CI, 0.069-0.794, p<0.05). Conclusions The prevalence of GER is high in the symptomatic preterm infants. GER aggravates the respiratory and digestive symptoms holding that not all the symptoms are GER associated. Probiotics and delayed full oral feeds can decrease the prevalence of GER.

scholarly journals Effects on Gastroesophageal Reflux of Donkey Milk-Derived Human Milk Fortifier Versus Standard Fortifier in Preterm Newborns: Additional Data from the FortiLat Study

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2142 ◽  
Author(s):  
Francesco Cresi ◽  
Elena Maggiora ◽  
Alice Pirra ◽  
Paola Tonetto ◽  
Carlotta Rubino ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gastric Emptying ◽  
Gastroesophageal Reflux ◽  
Human Milk ◽  
Preterm Infants ◽  
Feeding Intolerance ◽  
Donkey Milk ◽  
Gastric Emptying Time ◽  
Human Milk Fortifier ◽  
Emptying Time

Background: Feeding intolerance is a frequent diagnosis in very preterm infants. As seen in the FortiLat trial, human milk fortification with the new donkey milk-derived human milk fortifier (DF) seems to improve feeding tolerance in these infants. The aim of this study was to evaluate the effects of using the DF compared with bovine milk-derived fortifier (BF) on gastroesophageal reflux (GER) in very low birth weight (VLBW) infants. Methods: Over a total of 156 preterm infants were enrolled into the FortiLat trial (GA <32 weeks and birth weight <1500 g) and randomized into the BF arm or DF arm, and we selected all infants with clinical signs of GER and cardiorespiratory (CR) symptoms. All the infants underwent CR and multichannel intraluminal impedance and pH (MII/pH) monitoring associated with gastric ultrasound to evaluate GER and gastric emptying time. Results: 10 infants were enrolled, and 5 were in the DF arm. At MII/pH, infants enrolled into the DF arm showed a lower GER frequency than BF arm infants (p = 0.036). Half gastric emptying time was similar in DF and BF arm infants (p = 0.744). Conclusion: The use of donkey-derived human milk fortifier reduced the GER frequency and consequently should be recommended in infants with feeding intolerance.

scholarly journals Prevalence and Risk Factors for Gastroesophageal Reflux in Symptomatic Very Preterm Neonates

2020 ◽  
Author(s):  
Yu Hu ◽  
Hua Fu ◽  
Cheng Zhang
Keyword(s):  
Risk Factors ◽  
Gastroesophageal Reflux ◽  
Preterm Infants ◽  
Preterm Neonates ◽  
Very Preterm ◽  
Intraluminal Impedance ◽  
Immature Development ◽  
Impedance Monitoring ◽  
The Relationship ◽  
Poor Weight Gain

Abstract Objectives Because of immature development, preterm infants are prone to respiratory and digestive symptoms, such as dyspnea, vomiting, and aspiration pneumonia. These symptoms are often observed in infants with gastroesophageal reflux (GER). However, the relationship between GER and these symptoms remains unclear.Methods A cohort of 61 preterm infants born at 32 weeks of gestation or earlier with respiratory or digestive symptoms were retrospectively reviewed. All the preterm infants underwent 24-hour pH-multichannel intraluminal impedance monitoring. Clinical data were analyzed using logistic regression analyses.Results Among the 61 symptomatic preterm infants, 34 were positive for pathologic GER with a prevalence of 55.7%. The GER-associated symptoms included apnea (42.6%), cyanosis (19.7%), vomiting (14.8%), pneumonia (9.8%), and poor weight gain (13.1%). These respiratory and digestive symptoms were more frequent in infants with pathologic GER than in those without (p<0.05). The risk factors for GER included severe bronchopulmonary dysplasia (odds ratio [OR], 6.890; 95% confidence interval [CI], 1.125-42.209). Probiotics and delayed full oral feeds reduced the risk of GER (OR, 0.642; 95% CI, 0.457-0.901, p<0.05; OR, 0.234, 95% CI, 0.069-0.794, p<0.05). Conclusions The prevalence of GER is high in symptomatic preterm infants. GER aggravates the respiratory and digestive symptoms; however, such symptoms are not always GER-associated. Probiotics and delayed full oral feeds can decrease the prevalence of GER.

Influence of nasogastric tubes on gastroesophageal reflux in preterm infants: A multiple intraluminal impedance study

2002 ◽  
Vol 141 (2) ◽  
pp. 277-279 ◽  
Author(s):  
Corinna S. Peter ◽  
Cornelia Wiechers ◽  
Bettina Bohnhorst ◽  
Jiri Silny ◽  
Christian F. Poets
Keyword(s):  
Gastroesophageal Reflux ◽  
Preterm Infants ◽  
Impedance Study ◽  
Nasogastric Tubes ◽  
Intraluminal Impedance

Composition and fortification of human milk influence gastroesophageal reflux in preterm infants

2008 ◽  
Vol 40 (10) ◽  
pp. A114
Author(s):  
L. Corvaglia ◽  
A. Aceti ◽  
E. Mariani ◽  
B. Battistini ◽  
V. Paoletti ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Human Milk ◽  
Preterm Infants

Effects of Thickened Feeding on Gastroesophageal Reflux in Infants: A Placebo-Controlled Crossover Study Using Intraluminal Impedance

PEDIATRICS ◽  
2003 ◽  
Vol 111 (4) ◽  
pp. e355-e359 ◽  
Author(s):  
T. G. Wenzl ◽  
S. Schneider ◽  
F. Scheele ◽  
J. Silny ◽  
G. Heimann ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Crossover Study ◽  
Intraluminal Impedance

scholarly journals Effects on gastroesophageal reflux of donkey milk-derived human milk fortifier versus standard fortifier in preterm newborns. Additional data from Fortilat study.

2020 ◽  
Author(s):  
Francesco Cresi ◽  
Elena Maggiora ◽  
Alice Pirra ◽  
Paola Tonetto ◽  
Carlotta Rubino ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Gastroesophageal Reflux ◽  
Human Milk ◽  
Preterm Infants ◽  
Ph Monitoring ◽  
Bovine Milk ◽  
Clinical Signs ◽  
Donkey Milk ◽  
Symptom Association Probability ◽  
Human Milk Fortifier

Abstract Background : Feeding intolerance, defined as the inability to digest enteral feeding, is a frequent diagnosis in very preterm infants. It is characterized by abdominal distension, delayed gastric emptying and increased frequency and severity of gastroesophageal reflux (GER). As seen in the FortiLat trial, human milk fortification with the new donkey milk-derived human milk fortifier (DF) seems to improve feeding tolerance in these infants. The aim of this ancillary study of the FortiLat trial was to evaluate the effects of using the DF compared with bovine milk-derived fortifier (BF) on GER in VLBW infants.Methods : Over a total of 156 preterm infants enrolled into the FortiLat trial (gestational age <32 weeks and/or birth weight <1500 g) and randomized into BF-arm or DF-arm we selected all infants with clinical signs of GER and cardiorespiratory (CR) symptoms at day 21 of fortification. All the infants underwent CR and multichannel intraluminal impedance and pH (MII/pH) monitoring associated with gastric ultrasound to evaluate GER characteristics, GER-CR temporal associations and gastric emptying time.Results : 10 infants were enrolled, 5 in the DF-arm. At MII/pH infants enrolled into the DF-arm showed a lower GER frequency than BF-arm infants: 2.02(1.95-3.26) vs 4.82(2.84-5.94) GER/hour (p=0.036). No infant had a significant symptom association probability index between GER and CR events. Half gastric emptying time was similar in DF and BF-arm infants: 45.03(42.74-47.02) vs. 48.57(44.73-48.77) min. (p=0.744)Conclusions : The use of donkey derived human milk fortifier reduced the GER frequency and consequently should be recommended in infants with feeding intolerance.Trial Registration : ISRCTN -ISRCTN70022881. Registered 01May 2014 - Retrospectively registered, http://www.isrctn.com/ISRCTN70022881

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