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