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PEDIATRICS Vol. 102 No. 6 December 1998, p. e67

ELECTRONIC ARTICLE:
One-Year Follow-up of Symptoms of Gastroesophageal Reflux During Infancy

Received Feb 3, 1998; accepted Jul 20, 1998.

Suzanne P. Nelson*, Edwin H. Chen§, Gina M. Syniar*, Katherine Kaufer ChristoffelDagger , §, and for the Pediatric Practice Research Group

From the Department of Pediatrics, * Divisions of Gastroenterology, Hepatology and Nutrition, and Dagger  General Academic Pediatrics, and the § Statistical Sciences and Epidemiology Program, Northwestern University and Children's Memorial Medical Center, Chicago, Illinois.

Objectives.  1) Determine what percentage of infants outgrow regurgitation over 1 year. 2) Determine whether they develop feeding or mealtime problems. 3) Determine whether they develop frequent respiratory illnesses, including ear, sinus, and upper respiratory infections, or wheezing episodes.

Design.  One-year follow-up survey of parents of children identified at 6 to 12 months of age as those who regurgitate (case subjects) and matched control subjects.

Participants.  Sixty-three case subjects and 92 control subjects attending 12 different (urban, suburban, and rural) practices in the Pediatric Practice Research Group in the Chicago area.

Primary Outcome Measures.  The Infant Gastroesophageal Reflux Questionnaire-Shortened and Revised Form and the Children's Eating Behavior Inventory (CEBI).

Results.  At 1-year follow-up, no parents of case or control subject described spitting up as currently a problem. The parent of only one control subject (and no case subject) reported spitting up one or more times a day. Parents of subjects were more likely than those of control subjects to report frequent feeding refusal: odds ratio = 4.2, adjusted by age (95% confidence interval: 1.4-12.0). Case and control subjects had comparable average total CEBI scores (case subjects, &xmacr; = 83 ± 10 vs control subjects, &xmacr; = 82 ± 11) and comparable average proportion of items identified as a problem (8% ± 11% case subjects vs 6% ± 9% control subjects). Case subjects were more likely to respond positively to two CEBI questions indicating specific feeding problems: 1) "my child takes more than an hour to eat his/her meals" (8% case subjects vs 0% control subjects) and 2) "I get upset when I think about our meals" (14% case subjects vs 4% control subjects). The frequencies of ear, sinus, and upper respiratory infections and of episodes of wheezing were comparable in both groups.

Conclusions.  1) Infants with daily or problematic regurgitation at 6 to 12 months of age outgrew this within the following year. 2) Infants with daily or problematic regurgitation were more likely to develop feeding problems. 3) There was no increase in respiratory illnesses in infants with a history of regurgitation.  Key words:  gastroesophageal reflux, infants, practice-based research, epidemiology, feeding problems, natural history.