Thickening of infant feedings for therapy of gastroesophageal reflux

To assess the effect of thickening of feedings on gastroesophageal reflux and gastric emptying, 20 infants were examined with technetium scintigraphy and detailed behavioral observation after each of a pair of feedings, one with radiolabeled infant formula alone and the other with radiolabeled formula thickened with dry rice cereal. The thickened and unthickened meals were followed by similar amounts of scintigraphically demonstrated gastroesophageal reflux. However, the number of episodes of emesis (1.2±0.7 vs 3.9±0.9 per 90 minutes postprandial), the percent of gastric emptying at 30 minutes (17.8%±2.7% vs 22.4%±2.4%), the time spent crying (11.7±3.1 minutes vs 17.6±3.8 minutes per 90 minutes), and the total time spent awake (45.2±5.9 minutes vs 53.1±4.9 minutes per 90 minutes) were significantly less after the thickened feedings. Because thickening of infant feedings increases the caloric density, decreases emesis, decreases crying time, and increases sleep time in the postprandial period, it is likely to be beneficial in the treatment of infants with gastroesophageal reflux associated with failure to thrive.