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Dietary treatment for regurgitation--recommendations from a working party
Y Vandenplas1, D Belli, S Cadranel
1Academisch Ziekenhuis Kinderen, Brussels, Belgium.
Insights
Infant regurgitation is common. Dietary treatments, including thickened infant formula, should be medically supervised and proven effective and safe before use.
Area of Science:
- Pediatrics
- Infant Nutrition
- Gastroenterology
Background:
- Infant regurgitation is a frequent concern for parents and healthcare providers.
- Current management involves reassurance, dietary changes, and sometimes prokinetics.
- The efficacy and safety of dietary interventions require careful evaluation.
Purpose of the Study:
- To evaluate the efficacy, safety, and nutritional aspects of dietary management for infant regurgitation.
- To assess the role of thickened infant feeds and anti-regurgitation (AR) formulae.
- To propose criteria for the appropriate use of AR formulae.
Main Methods:
- Review of current therapeutic strategies for infant regurgitation.
- Analysis of the composition and nutritional implications of thickened infant feeds.
- Evaluation of the evidence supporting the use of anti-regurgitation formulae.
Main Results:
- Thickened feeds, whether industrially prepared or home-thickened, vary in composition (e.g., fiber, lipid, casein content).
- Formulae marketed as 'anti-regurgitation' should be classified as medical foods.
- Clinical evidence of efficacy and nutritional safety is crucial for AR formulae.
Conclusions:
- Dietary management of infant regurgitation requires careful consideration of feed composition and safety.
- Anti-regurgitation formulae should be prescribed only when clinically proven effective and nutritionally sound.
- The 'AR' label should be restricted to diets meeting stringent efficacy and safety standards.
Abstract:
Regurgitation is a common manifestation in infants below the age of 1 y, and is a frequent reason for counselling of general practitioners and paediatricians. Current recommended therapeutic management starts with parental reassurance and dietary measures, followed by prokinetics. In this paper, the efficacy, safety and nutritional implications of the dietary treatment of regurgitation are evaluated. Industrially prepared thickened feeds may contain cereals of fibres; some have a low lipid content and are casein-predominant. Milk-thickened agents can also be added to regular infant feeding. Formulae claimed as "anti-regurgitation formulae", or positioned as such, should be considered as medical foods or therapeutic diets, and only be available on medical prescription. It is proposed to limit the "anti-regurgitation" (AR) label to those diets which have been proven clinically effective on regurgitation and which are nutritionally safe.