Impact of Feeding Strategies on the Frequency and Clearance of Acid and Nonacid Gastroesophageal Reflux Events in Dysphagic Neonates
| Autor: | Sudarshan R. Jadcherla, Rebecca K. Moore, Chin Yee Chan, Manish B. Malkar, Christopher J. Timan, Christina J. Valentine |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Medicine (miscellaneous) Feeding duration Gastroenterology Article Enteral Nutrition Esophagus Internal medicine medicine Electric Impedance Humans Nutrition and Dietetics Milk Human business.industry fungi Reflux Infant Newborn Feeding Behavior Hydrogen-Ion Concentration Postprandial Period Dysphagia Infant Formula medicine.anatomical_structure Postprandial Parenteral nutrition Infant formula Gastroesophageal Reflux Female Analysis of variance medicine.symptom business Deglutition Disorders Energy Intake |
| Popis: | Feeding difficulties and gastroesophageal reflux (GER) are common problems in neonates. The authors hypothesize that GER could be influenced by feeding mechanics by evaluating the effects of feeding volumes, feeding durations, feeding flow rates, and caloric density on the chemical composition and clearance of GER in dysphagic neonates.Symptomatic dysphagic neonates (n = 35) underwent evaluation for suspected GER using pH-impedance methods.The proportions of acid and nonacid GER were different during the first, second, and third postprandial hours (P.0001). Prolonged feeding duration was significantly associated with decreased total, nonacid GER and BCT (P.03). Significant positive correlations (P.05) were detected between feeding flow rate vs frequency of total, nonacid GER and BCT. Significant positive correlation (P = .002) was noted between feeding volume and BCT. BCT decreased with each hourly interval (analysis of variance [ANOVA] P.05); however, ACT increased with each hourly interval (ANOVA P = .05). Comparison between BCT and ACT at each postprandial hour is remarkable for longer ACT during the second and third hours after the initiation of feed (P ≤ .001). No significant correlation was noted between the milk types (breast milk or formula) or caloric density with regard to the GER characteristics. Oral-fed infants had more GER events than gavage-fed infants.Prolonged feeding durations and slower flow rates are associated with decreased frequency of GER. Modification of feeding duration and flow rate can be a useful adjunct to ameliorate GER in dysphagic neonates. |
| Databáze: | OpenAIRE |
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