Hegar Badriul, Rantos Rastra, Firmansyah Agus, De Schepper Jean, Vandenplas Yvan
Department of Child Health, Universitas Indonesia, Depok, Indonesia.
J Pediatr Gastroenterol Nutr. 2008 Jul;47(1):26-30. doi: 10.1097/MPG.0b013e31815eeae9.
Regurgitation is frequent in infants. We evaluated changes in regurgitation among patient groups fed standard formula, standard formula subsequently thickened with cereal, or formula manufactured with bean gum as a thickening agent.
A prospective, blinded, randomised 1-month intervention trial evaluating the efficacy of parental reassurance of the regurgitating child in combination with 3 formula interventions--standard infant formula (group A); 5 g of rice cereal added to 100 mL standard formula (group B); and formula manufactured with bean gum as a thickening agent (group C)--was performed in 60 infants presenting with more than 4 episodes of regurgitation and/or vomiting per day during the week before inclusion. Formula intake, infant comfort, stool aspects, and weight gain were evaluated. All of the infants and data recorded by parents in a diary were evaluated weekly by a blinded health care professional.
At baseline, groups A, B, and C were similar for all of the parameters. After the 1-month intervention, regurgitation/vomiting decreased significantly in all 3 groups (P < 0.0005). Although the decrease was largest in group C (-4.2 +/- 2.1 episodes/day), the incidence did not differ significantly with groups A or B. At no evaluation interval was there a difference in volume of formula intake, infant comfort, stool frequency, or aspect. After 1 month, weight gain was significantly greater in group C compared with group A (19.9% vs 16.4%; P < 0.001).
Thickening of formula decreases regurgitation, but not significantly. Parental reassurance remains the cornerstone of the treatment of infant regurgitation.
反流在婴儿中很常见。我们评估了喂食标准配方奶粉、随后用谷物增稠的标准配方奶粉或用豆胶作为增稠剂生产的配方奶粉的患者组中反流情况的变化。
一项前瞻性、双盲、随机的1个月干预试验,评估对反流婴儿的父母进行安抚并联合3种配方奶粉干预措施的效果,这3种干预措施分别为:标准婴儿配方奶粉(A组);在100 mL标准配方奶粉中添加5 g米粉(B组);用豆胶作为增稠剂生产的配方奶粉(C组)。该试验纳入了60名在入组前一周每天出现4次以上反流和/或呕吐发作的婴儿。评估了配方奶粉摄入量、婴儿舒适度、粪便情况和体重增加情况。所有婴儿以及父母在日记中记录的数据每周由一名盲法医疗保健专业人员进行评估。
在基线时,A、B、C三组在所有参数方面均相似。1个月的干预后,所有3组的反流/呕吐情况均显著减少(P < 0.0005)。虽然C组减少幅度最大(-4.2±2.1次/天),但其发生率与A组或B组相比无显著差异。在任何评估时间段,配方奶粉摄入量、婴儿舒适度、粪便频率或粪便情况均无差异。1个月后,C组的体重增加显著高于A组(19.9%对16.4%;P < 0.001)。
配方奶粉增稠可减少反流,但不显著。对父母进行安抚仍然是婴儿反流治疗的基石。