Pediatrics Group Offers Tips for Managing GERD in Preterm Infants

By Kelly Young

Edited by André Sofair, MD, MPH

Pharmacologic agents "should be used sparingly" in preterm infants with gastroesophageal reflux, according to new guidance published in Pediatrics.

The American Academy of Pediatrics also recommended the following for gastroesophageal reflux, which is nearly universal among preterm infants:

• The signs of reflux — including feeding intolerance or aversion, poor weight gain, frequent regurgitation, apnea, desaturation, bradycardia, irritability, and perceived postprandial discomfort — generally improve over time without treatment.

• Nonpharmacologic treatments, such as head elevation and manipulating infant feeding, have not been proven to reduce reflux signs among preterm infants.

• Before discharge, parents should be educated on sleep safety, including not using devices designed to elevate the infant's head in the crib.

• Because of the lack of evidence of efficacy for drug treatments, along with evidence of potential harm, the authors say that "these agents should be used sparingly, if at all, in preterm infants."