THE RELATION BETWEEN GASTROESOPHAGEAL REFLUX, SLEEPING-POSITION AND SUDDEN INFANT DEATH AND ITS IMPACT ON POSITIONAL THERAPY

Many infants do regurgitate. The recommended therapeutic approach star ts with postural and dietary measures, followed by antacids and prokin etics. However, the recent findings regarding the increased risk for s udden infant death (SID) in the prone sleeping position challenge the current recommendations. Management of regurgitation should in the fir st place aim at reducing parental anxiety. Postural treatment favourin g the prone-elevated (30 degrees) position is no longer recommended as a first line treatment of regurgitation, despite its efficacy, becaus e of the unexplained association of SID with the flat prone sleeping p osition. Favouring the prone elevated position would result in an incr eased parental anxiousness. Conclusion Positional treatment can only b e recommended in children beyond the age of SID risk, or as an adjuvan t therapy in cases resistant to reassurance, thickeners and prokinetic s and in whom other diagnostic possibilities (infection, etc.) are con sidered rejected.