Prone and left lateral positioning reduce gastro-oesophageal reflux in preterm infants
A K Ewera b, M E Jamesa, J M Tobinb
a Neonatal Unit
Birmingham Women's Hospital
Edgbaston Birmingham
B15 2TG, b Institute of Child Health
University of Birmingham
Correspondence to: Dr Andrew Ewer Email: a.k.ewer{at}bham.ac.uk
Accepted 26 May 1999
AIM
To examine the
effect of body position on clinically significant gastro-oesophageal
reflux (GOR) in preterm infants.
METHODSEighteen
preterm infants with clinically significant GOR were studied
prospectively using 24 hour lower oesophageal pH monitoring. Infants
were nursed in three positions (prone, left, and right lateral) for 8 hours in each position, with the order randomly assigned. Data were
analysed using analysis of covariance.
RESULTSThe median
(range) reflux index (RI) for the group was 13.8% (5.8-40.4).
There was no significant difference in the mean time spent in
each position. RI (mean % (SEM)) was significantly less in prone (6.3 (1.7)) and left lateral positions (11.0 (2.2)), when compared with the
right lateral position (29.4 (3.2)); p<0.001. The mean (SEM) longest
episodes (mins) of GOR were reduced by prone and left positions (8.6 (2.2) and 10.0 (2.4), respectively) compared with the right position
(26.0 (3.9)); p<0.001. The mean (SE) number of episodes was reduced by
prone (15.4 (2.8)) and left (24.6 (3.5)) positions when compared with
right (41.6 (4.6)) (p<0.001).
CONCLUSIONSProne and
left lateral positions significantly reduce the severity of GOR, by
reducing the number of episodes and the duration of the longest
episodes. Such positioning offers a useful adjunct to the treatment in
hospital of preterm infants with gastro-oesophageal reflux.
Keywords: preterm; gastro-oesophageal reflux; body position
© 1999 by Archives of Disease in Childhood
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