Prone and left lateral positioning reduce gastro-oesophageal reflux in preterm infants. Issue 3 (1st November 1999)

• Record Type: Journal Article
• Authors: Ewer, A K; James, M E; Tobin, J M
• Is Part Of: Archives of disease in childhood. Volume 81:Issue 3(1999)
• Page Start: F201
• Page End: F205
• Publication Date: 1999-11-01
• Subjects: preterm -- gastro-oesophageal reflux -- body position; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/fn.81.3.F201
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : AIM: To examine the effect of body position on clinically significant gastro-oesophageal reflux (GOR) in preterm infants. METHODS: Eighteen preterm infants with clinically significant GOR were studied prospectively using 24 hour lower oesophageal pH monitoring. Infants were nursed in three positions (prone, left, and right lateral) for 8 hours in each position, with the order randomly assigned. Data were analysed using analysis of covariance. RESULTS: The median (range) reflux index (RI) for the group was 13.8% (5.8–40.4). There was no significant difference in the mean time spent in each position. RI (mean % (SEM)) was significantly less in prone (6.3 (1.7)) and left lateral positions (11.0 (2.2)), when compared with the right lateral position (29.4 (3.2)); p<0.001. The mean (SEM) longest episodes (mins) of GOR were reduced by prone and left positions (8.6 (2.2) and 10.0 (2.4), respectively) compared with the right position (26.0 (3.9)); p<0.001. The mean (SE) number of episodes was reduced by prone (15.4 (2.8)) and left (24.6 (3.5)) positions when compared with right (41.6 (4.6)) (p<0.001). CONCLUSIONS: Prone and left lateral positions significantly reduce the severity of GOR, by reducing the number of episodes and the duration of the longest episodes. Such positioning offers a useful adjunct to the treatment in hospital of preterm infants with gastro-oesophageal reflux.