A 6-month-old child regularly regurgitates a large portion of his feeds. A pH probe study shows significant periods of low esophageal pH. The child has normal growth and no other s... A 6-month-old child regularly regurgitates a large portion of his feeds. A pH probe study shows significant periods of low esophageal pH. The child has normal growth and no other significant past medical history. Which of the following is the the most appropriate management?
Understand the Problem
The question describes a 6-month-old infant with regurgitation and low esophageal pH, indicating gastroesophageal reflux (GER). The infant has normal growth and no other medical issues. The question asks us to determine the most appropriate management option.
Answer
Conservative management is most appropriate, employing strategies such as smaller, more frequent feeds, upright positioning after feeding, and possibly thickening feeds.
Given the child's normal growth and the absence of other significant medical history, the most appropriate management is likely conservative. This may include strategies such as smaller, more frequent feeds, keeping the child upright after feeding, and potentially thickening feeds with cereal.
Answer for screen readers
Given the child's normal growth and the absence of other significant medical history, the most appropriate management is likely conservative. This may include strategies such as smaller, more frequent feeds, keeping the child upright after feeding, and potentially thickening feeds with cereal.
More Information
The scenario describes a situation where an infant is experiencing gastroesophageal reflux (GER) with acidic esophageal pH, but is otherwise healthy and growing normally. This suggests uncomplicated GER, rather than gastroesophageal reflux disease (GERD).
Tips
A common mistake is to immediately jump to pharmacological interventions without first trying conservative management, especially in infants with normal growth and no other complications.
Sources
- Regurgitation in healthy and non healthy infants - PMC - pmc.ncbi.nlm.nih.gov
- Gastro-Esophageal Reflux in Children - PMC - PubMed Central - pmc.ncbi.nlm.nih.gov
- Pediatric Gastroesophageal Reflux Treatment & Management - emedicine.medscape.com
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