Managing gastroesophageal reflux symptoms in the very low-birth-weight infant postdischarge

Area of Science:

• Neonatal care
• Pediatric gastroenterology
• Evidence-based practice

Background:

• Gastroesophageal reflux (GER) and GER disease (GERD) symptoms are prevalent in very low-birth-weight (VLBW) infants (<1500 g).
• These symptoms often lead to feeding difficulties, impaired infant-caregiver feeding relationships, and significant family stress.
• Inconsistent management approaches across healthcare disciplines, potentially not evidence-based, can cause confusion and delayed interventions for families.

Purpose of the Study:

• To develop a standardized algorithm for managing GER-like symptoms in VLBW infants from hospital discharge to 12 months corrected age.
• To promote consistent identification of symptoms and application of management strategies.
• To guide timely medical consultations for VLBW infants experiencing GER symptoms.

Main Methods:

• Formation of a multidisciplinary community of practice.
• Critical appraisal of existing literature on GER management in VLBW infants.
• Development and case study application of a management algorithm.

Main Results:

• The algorithm provides a consistent framework for managing GER symptoms in VLBW infants.
• It aids in identifying symptoms, applying evidence-based management, and determining the need for medical consultation.
• A case study illustrated the algorithm's utility in clinical practice.

Conclusions:

• A structured, evidence-based algorithm can standardize GER symptom management in VLBW infants.
• Consistent management improves infant outcomes and supports the infant-caregiver feeding relationship.
• The algorithm offers a valuable tool for clinicians caring for VLBW infants post-discharge and in the NICU setting.