Efficacy of telephone teaching of conservative therapy for infants with symptomatic gastroesophageal reflux referred by pediatricians to pediatric gastroenterologists

Abstract

Objectives To evaluate the efficacy of a specific protocol of conservative therapy for infant gastroesophageal reflux. Study design Retrospective evaluation of the response to telephone teaching of conservative therapy by a single instructor as part of the screening process for a pharmacotherapy study of infantile reflux. Feeding modifications included the use of a protein-hydrolysate formula thickened with one tablespoon of dry rice cereal per ounce, at restricted volumes. Positioning changes included avoidance of seated and supine positions. Elimination of all tobacco smoke exposure was advised. Setting: Single-center, outpatient. Subjects: 394 infants <12 months old. Analysis: Efficacy: the percentage responding to conservative therapy instruction. Factors possibly predicting success for isolated conservative therapy instruction: evaluated as explanatory variables by χ2 analysis; significance at P <.05. Results Ninety-six infants (24%) had sufficient symptom improvement and no additional intervention was required. Infants with isolated vomiting or irritability were more likely to respond than infants with both or other symptoms (P <.001). Neither formula type fed nor use of pharmacotherapy at referral were significant in determining response to conservative therapy. Conclusions As many as 24% of infants with gastroesophageal reflux disease may respond to conservative therapy instruction provided by telephone. Benefits include savings of cost, time, and drug exposure of infants. (J Pediatr 2003;142:57-61)