Effect of body position changes on postprandial gastroesophageal reflux and gastric emptying in the healthy premature neonate

Michiel P. van Wijk, Marc A. Benninga, John Dent, Ros Lontis, Louise Goodchild, Lisa M. McCall, Ross Haslam, Geoffrey P. Davidson, Taher Omari

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Abstract

Objective To identify a body-positioning regimen that promotes gastric emptying (GE) and reduces gastroesophageal reflux (GER) by changing body position 1 hour after feeding. Study design Ten healthy preterm infants (7 male; mean postmenstrual age, 36 weeks [range, 33 to 38 weeks]) were monitored with combined esophageal impedance-manometry. Infants were positioned in the left lateral position (LLP) or light lateral position (RIP) and then gavage-fed. After 1 hour, the position was changed to the opposite side. Subsequently, all infants were restudied with the order of positioning reversed. Results There wits more liquid GER in the RLP than in the LLP (median, 9.5 [range, 6.0 to 22.0] vs 2.0 [range, 0.0 to 5.0] episodes/hour; P =.002). In the RLP-first protocol, the number of liquid GER episodes per hour decreased significantly after position change (first postprandial hour [RLP], 5.5 [2.0 to 13.0] vs second postprandial hour [LLP], 0.0 [0.0 to 1.0]; P=.002). GE was faster in the RLP-first protocol than in the LLP-first protocol (37.0 +/- 21.1 vs 61.2 +/- 24.8 minutes; P =.006). Conclusions A strategy of right lateral positioning for the first postprandial hour with it position change to the left thereafter promotes GE and reduces liquid GER in the late postprandial period and may prove to be it simple therapeutic approach for infants with GER disease
Original languageEnglish
Pages (from-to)585-590
JournalJournal of pediatrics
Volume151
Issue number6
DOIs
Publication statusPublished - Dec 2007

Keywords

  • Cross-Over Studies
  • Electric Impedance
  • Esophagus/physiology
  • Female
  • Gastric Emptying/physiology
  • Gastroesophageal Reflux/physiopathology
  • Humans
  • Hydrogen-Ion Concentration
  • Infant
  • Infant, Newborn
  • Infant, Premature, Diseases/physiopathology
  • Infant, Premature/physiology
  • Male
  • Manometry
  • Postprandial Period
  • Posture/physiology

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