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

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Hegar Badriul, Satari Debora Hindra I., Sjarif Damayanti R., Vandenplas Yvan,
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 ( Hegar Badriul ) 
University of Indonesia Cipto Mangunkusumo Hospital Department of Child Health, Faculty of Medicine

 ( Satari Debora Hindra I. ) 
University of Indonesia Cipto Mangunkusumo Hospital Department of Child Health, Faculty of Medicine
 ( Sjarif Damayanti R. ) 
University of Indonesia Cipto Mangunkusumo Hospital Department of Child Health, Faculty of Medicine
 ( Vandenplas Yvan ) 
Belgium Vrije Universiteit Brussel Universitair Kinderziekenhuis Brussel Department of Pediatrics

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 (£¾3 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 ¡°weightfor 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 sig-nificant 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.

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

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