CURRENT CONCEPTS AND ISSUES IN THE MANAGEMENT OF REGURGITATION OF INFANTS - A REAPPRAISAL

Regurgitation in infants is a common problem. Recent issues, such as t he increased risk of sudden infant death in the prone sleeping positio n, the finding of persisting occult gastro-oesophageal reflux with fee d thickeners, and the increasing awareness of the cost-benefit ratio o f medications may challenge the currently recommended management appro ach. A round table was organized to elaborate on the impact of (i) the pro supine sleeping campaigns in relation to sudden infant death and (ii) advancement in medical treatment on therapeutic strategies in reg urgitating infants. The participants were opinion leaders from Europe and North America (Belgium, Canada, France, UK, Italy, Switzerland and The Netherlands). The importance of parental reassurance is stressed. As a consequence of the supine sleeping campaigns aiming to decrease the incidence of sudden infant death syndrome, the ''prone elevated sl eeping position'' is no longer advised as a first-line therapeutic app roach, although it is still recommended in ''complicated reflux''. It is emphasized that milk thickeners are an adequate therapeutic tool fo r regurgitation, but not in reflux disease. According to the literatur e, the efficacy of (alginate-)antacids, although very popular in some countries, is questionable. These recommendations will be of interest to first-line paediatricians, since about 40% of their patients, accor ding to the literature, present because of regurgitation.