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Evid Based Nurs 8:74 doi:10.1136/ebn.8.3.74
  • Treatment

Review: thickened feeds or metoclopramide may reduce symptoms of gastro-oesophageal reflux in healthy infants


 
 Q What is the effectiveness of thickened feeds, positioning, and metoclopramide for treatment of gastro-oesophageal reflux (GER) in developmentally normal infants 1–24 months of age?

METHODS

GraphicData sources:

Cochrane Central Register of Controlled Trials (Cochrane Library, Issue 1, 2003), Medline (1966 to January 2003), EMBASE/Excerpta Medica (1985 to January 2003), and reference lists of retrieved reviews.

GraphicStudy selection and assessment:

randomised controlled trials that compared thickened feeds with unthickened feeds; metoclopramide with no intervention or placebo; or various positions in developmentally normal children 1–24 months of age with GER (diagnosed by signs or symptoms or pH monitoring). 3 independent reviewers assessed the methodological quality of individual studies using the Jadad scale.

GraphicOutcomes:

signs and symptoms of GER (regurgitation, respiratory symptoms, and weight gain), reflux index (percentage of total time oesophageal pH <4), number of reflux episodes, number of reflux episodes lasting >5 minutes per unit time, adverse effects such as coughing (thickened feeds) and fussiness, drowsiness, and extrapyramidal reactions (metoclopramide).

MAIN RESULTS

20 trials met the selection criteria. 8 trials (median sample size 26; 3 had Jadad scores ⩾3/5) assessed the …

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