Pediatr Gastroenterol Hepatol Nutr.  2013 Dec;16(4):240-247.

Regurgitation and Gastroesophageal Reflux Disease in Six to Nine Months Old Indonesian Infants

• Hegar B
• Satari DH
• Sjarif DR
• Vandenplas Y

Abstract

PURPOSE
Regurgitation is known to peak at the age of 3-4 months, with a sharp decrease around the age of 6 months. Little is known about the natural evolution of infants who still regurgitate after the age of 6 months.
METHODS
Hundred thirty-one infants older than 6 months regurgitating more than once a day were followed for a period of 3 months.
RESULTS
According to our data, gastroesophageal reflux disease (GERD) is seldom at this age. Most of the infants regurgitated 3 or more times/day and spit up an estimated volume of more than 15 mL. Eighty-five parents were educated regarding frequency of feeding. There were only 6 infants that still had frequent regurgitation (>3 times/day) despite an appropriate feeding schedule. The Infant GER Questionnaire score reached a score of 0 in 50% of the infants after one month of follow-up and in 81.9% at the third month of follow-up. There was an increase of the "weight for age z-score" trends in infants that still regurgitated at the end of follow-up and a declining z-score in infants that no longer regurgitated. An explanation may be that infants that regurgitate drink larger volumes than infants who do not regurgitate. Conservative treatment (reassurance, dietary treatment, behavioral advice) resulted in a significant better outcome than natural evolution.
CONCLUSION
Regurgitation that persisted after the age of 6 months, strongly decreased during a 3-month follow-up with conservative treatment. GERD is rare in this age group; therefore, anti-reflux medication is only seldom needed.

Keyword

Gastroesophageal reflux; Infant; Gastric regurgitation; Reassurance; Dietary treatment

MeSH Terms

Appointments and Schedules
Follow-Up Studies
Gastroesophageal Reflux*
Humans
Infant*
Laryngopharyngeal Reflux
Parents
Surveys and Questionnaires

Figure

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  Fig. 1 Infant Gastroesophageal Reflux Questionnaire (I-GERQ) score at enrollment and during follow-up.

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  Fig. 2 Linear trend of "weight for age z-score" in infants that still regurgitate at the end of the 3 months follow-up.

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  Fig. 3 Linear trend of "weight for age z-score" in infants that do not regurgitate at the end of the 3 months follow-up.

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