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

https://doi.org/10.1136/ebn.8.3.74

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    Craig WR, Hanlon-Dearman A, Sinclair C, et al. Metoclopramide, thickened feedings, and positioning for gastro-oesophageal reflux in children under two years. Cochrane Database Syst Rev 2004;(4):CD003502.

    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

    Embedded ImageData 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.

    Embedded ImageStudy 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.

    Embedded ImageOutcomes:

    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 …

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    Footnotes

    • For correspondence: Dr W R Craig, Pediatrics, University of Alberta, Edmonton, Alberta, Canada. wcraigcha.ab.ca

    • Source of funding: not stated.