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Subject:
From:
Carlos Gonzalez <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 17 May 1996 18:49:44 +-200
Content-Type:
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Deborah:
How was Logan reflux diagnosed? Barium swallow?
There is an excellent revision:
Hillemeier AC: Gastroesophageal Reflux. Ped Clin N Amer 1996;43:197
Excerpts from it:
"Because most infants have some degree of GER, one should not automatically
assume a cause-and-efect relationship between the symptoms of GER and other
health-related conditions, such as growth problems, respiratory disease,
apnea or behavioral problems."
"...the correlation of apneic episodes with GER usually does not exist"
"many infants who have little or no clinical symptoms of reflux experience
reflux of some barium into the esophagus"
"thickened feedings (e.g. apple juice thickened with rice cereal) were
found to have no effect on reflux time, unless the child was in a
head-elevated prone position after the feeding"
"thickened feedings in some infants may result in an increased number of
coughing episodes" (J Pediatr 1992;121:913)
In plain English: reflux, if real, if probably only a coincidence and not
 the cause of apnea. Rice has no clear benefits, and (at 2 months age)
many risks (intolerance, bacterial contamination, reduced breastmilk
intake, nutrient deficiency...). If someone really thinks this infant is at
risk of SIDS, a more sensitive approach would be to encourage exclusive
breastfeeding, the baby sleeping in the parent's room and no one smoking at
home.
Best wishes             Carlos Gonzalez, MD (Ped)

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