Orenstein S R
Department of Pediatrics, University of Pittsburgh School of Medicine, PA 15213.
Pediatr Res. 1988 Jul;24(1):38-40. doi: 10.1203/00006450-198807000-00010.
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.
为评估使用安抚奶嘴（非营养性吸吮）对婴儿胃食管反流的影响，对48名6个月以下患有病理性反流的婴儿进行了pH探头前瞻性评估。在交叉设计的配对时间段内，当鼓励或禁止使用安抚奶嘴时，对每名婴儿反流参数进行盲法量化。为确定体位是否是影响非营养性吸吮对反流作用的一个因素，对其中24名婴儿采取坐位进行研究，另外24名采取俯卧位进行研究。使用安抚奶嘴仅显著影响反流发作频率，使俯卧位婴儿餐后120分钟内的反流发作频率从7.2±1.1次增加至12.8±2.3次（p = 0.040），使坐位婴儿餐后反流发作频率从21.1±3.1次降至14.8±2.6次（p = 0.003），禁食期从17.3±4.8次降至5.9±0.9次（p = 0.035）。它对反流发作的清除或总反流时间没有显著影响。这些结果表明，患有病理性反流的婴儿在处于有益的俯卧位时可能最好避免使用安抚奶嘴。当必须采取坐位时，非营养性吸吮的安抚作用可能有助于减少反流事件以及减少哭闹行为。
