谷物增稠配方奶及竖抱体位对反流婴儿反流、胃排空及体重增加的影响

Effect of cereal-thickened formula and upright positioning on regurgitation, gastric emptying, and weight gain in infants with regurgitation.

作者信息

Chao Hsun-Chin, Vandenplas Yvan

机构信息

Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University Medical College, Taoyuan, Taiwan.

出版信息

Nutrition. 2007 Jan;23(1):23-8. doi: 10.1016/j.nut.2006.10.003.

DOI:10.1016/j.nut.2006.10.003

PMID:17189087

Abstract

OBJECTIVE

We compared the effect of cereal-thickened formula or postural therapy on regurgitation and gastroesophageal reflux, weight gain, and gastric emptying in infants.

METHODS

We performed a prospective trial in exclusively formula-fed infants 2 to 6 mo of age presenting with regurgitation or vomiting at least three times a day. Infants were randomized into two groups; group A received cereal-thickened formula versus group B who were placed in a postprandial upright position for 90 min and evaluated over an 8-wk period. A 90-min technetium 99m milk scintigraphy was performed before and at the end of the intervention period.

RESULTS

Thirty-one infants were included in group A and 32 in group B; at inclusion, there were no anthropometric differences between groups (P = 0.813-0.955). After 4 and 8 wk, the difference in regurgitation frequency per day between groups A and B had become significant (at 4 wk, 2.39 +/- 0.86 for group A versus 2.84 +/- 0.81 for group B, P = 0.039; at 8 wk, 1.61 +/- 0.76 for group A versus 2.38 +/- 0.83 for group B, P < 0.001). The volume ingested per meal was not different between groups after 4 wk, although this parameter showed a larger intake in group A after 8 wk (156.8 +/- 23.5 mL for group A versus 143.4 +/- 25.1 mL for group B, P = 0.035), resulting in a significant difference in mean caloric intake. Gastric emptying after 8 wk showed no significant difference between groups A and B. Group A infants had significantly greater weight gain than did group B infants after 4 wk (636.2 +/- 103.4 g for group A versus 577.4 +/- 102.7 g for group B, P = 0.03) and 8 wk (1261.3 +/- 131.4 g for group A versus 1121.4 +/- 137.2 g for group B, P < 0.001). After 8 wk of intervention, the increase in length was significantly greater in group A than in group B (5.2 +/- 0.6 cm for group A versus 4.7 +/- 0.6 cm for group B, P = 0.032).

CONCLUSION

Cereal-thickened formula is significantly more efficacious than postural therapy in decreasing the frequency of regurgitation in regurgitating infants. Treatment of regurgitation with cereal-thickened formula results in an increased caloric intake ( approximately 25%), related to increased gain in weight and length, in comparison with regular formula and positioning therapy.

摘要

目的

我们比较了谷物增稠配方奶或体位疗法对婴儿反流、胃食管反流、体重增加和胃排空的影响。

方法

我们对2至6个月大、每天至少出现三次反流或呕吐症状的纯配方奶喂养婴儿进行了一项前瞻性试验。婴儿被随机分为两组；A组接受谷物增稠配方奶，B组在餐后保持直立姿势90分钟，并在8周内进行评估。在干预期开始前和结束时进行了90分钟的锝99m牛奶闪烁扫描。

结果

A组纳入31名婴儿，B组纳入32名婴儿；纳入时，两组之间的人体测量学指标无差异（P = 0.813 - 0.955）。4周和8周后，A组和B组之间每天反流频率的差异变得显著（4周时，A组为2.39 ± 0.86，B组为2.84 ± 0.81，P = 0.039；8周时，A组为1.61 ± 0.76，B组为2.38 ± 0.83，P < 0.001）。4周后两组每餐摄入的奶量没有差异，尽管8周后该参数显示A组摄入量更大（A组为156.8 ± 23.5 mL，B组为143.4 ± 25.1 mL，P = 0.035），导致平均热量摄入有显著差异。8周后A组和B组之间的胃排空没有显著差异。4周后A组婴儿的体重增加显著高于B组婴儿（A组为636.2 ± 103.4 g，B组为577.4 ± 102.7 g，P = 0.03），8周后也是如此（A组为1261.3 ± 131.4 g，B组为1121.4 ± 137.2 g，P < 0.001）。干预8周后，A组身长的增加显著大于B组（A组为5.2 ± 0.6 cm，B组为4.7 ± 0.6 cm，P = 0.032）。