Related Experiment Videos
Effect of nonnutritive sucking on infant gastroesophageal reflux
1Department of Pediatrics, University of Pittsburgh School of Medicine, PA 15213.
Insights
Pacifier use in infants with pathologic reflux impacts reflux frequency differently based on position. Avoid pacifiers when prone, but they may help when seated.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- Gastroesophageal reflux is common in infants.
- Nonnutritive sucking, or pacifier use, is a frequent behavior in infants.
- The effect of pacifier use on reflux in infants is not fully understood.
Purpose of the Study:
- To evaluate the effect of pacifier use on gastroesophageal reflux in infants.
- To determine if infant positioning modifies the effect of pacifier use on reflux.
Main Methods:
- 48 infants under 6 months with pathologic reflux were studied.
- A cross-over design was used, comparing pacifier use versus no pacifier use.
- Infants were studied in both seated and prone positions, with pH probe monitoring.
Main Results:
- Pacifier use significantly increased reflux frequency in the prone position (p=0.040).
- Pacifier use significantly decreased reflux frequency in the seated position, both postprandially (p=0.003) and during fasting (p=0.035).
- Pacifier use did not significantly affect reflux clearance or total reflux time.
Conclusions:
- Infants with pathologic reflux may benefit from avoiding pacifiers when in the prone position.
- Pacifier use may be beneficial in reducing reflux events and crying when infants are in a seated position.
Abstract:
To evaluate the effect of pacifier use (nonnutritive sucking) on gastroesophageal reflux in infants, 48 infants younger than 6 months of age with pathologic reflux were prospectively evaluated with pH probe. In each infant, parameters of reflux were blindly quantified during paired periods in a cross-over design when pacifier use was either encouraged or prohibited. To determine whether positioning was a factor in the effect of nonnutritive sucking on reflux, 24 of the infants were studied seated and 24 studied prone. Pacifier use significantly affected only the frequency of reflux episodes, increasing it in prone infants from 7.2 +/- 1.1 to 12.8 +/- 2.3 episodes/120 min postprandially (p = 0.040) and decreasing it in seated infants, from 21.1 +/- 3.1 to 14.8 +/- 2.6 postprandially (p = 0.003) and from 17.3 +/- 4.8 to 5.9 +/- 0.9 in the fasting period (p = 0.035). It did not significantly affect the clearance of reflux episodes or the total reflux time. These results suggest that infants with pathologic reflux frequency might best avoid pacifier use while in the beneficial prone position. When seated position is necessary, the pacifying effects of nonnutritive sucking may be useful in decreasing reflux events as well as in reducing crying behavior.