Sunday, January 24, 2010

Steeply Sloped Bed Reduces Regurgitation in Infants

From Reuters Health Information

NEW YORK (Reuters Health) Jan 15 An infant bed with a 40-degree slope helps minimize gastroesophageal reflux and associated problems, according to the findings of a pilot study from Belgium.

"The Multicare AR-Bed decreases infant regurgitation and improves quality of life of infants and parents," lead investigator Dr. Yvan Vandenplas told Reuters Health by email. "The bed significantly reduces the number of infants on medication for gastroesophageal reflux and thus decreases the side effects of medication."

In the January issue of the Archives of Disease in Childhood, Dr. Vandenplas of Universitair Ziekenhuis Kinderen, Brussels, and colleagues report on their study of 30 infants ages 3 weeks to 3 months. All had frequent regurgitation and reflux-associated symptoms, mainly during feeding, and 20 had been treated with proton pump inhibitors or other drugs.

Parents were instructed to place the baby in the bed, in a supine position, after feeding and to leave the baby there as long as he or she was comfortable.

Eight of the infants did not tolerate the bed positioning and were withdrawn from the study within 2 days. Also, by the end of the 1-week study, 3 of the 22 remaining babies had not responded. Considering these 3, plus the 8 who dropped out, the researchers observe that the bed "did not improve symptoms" in 11 patients (37%).

In an intent-to-treat analysis of the entire 30-baby cohort, however, there were significant reductions in daily incidence of regurgitation (p<0.001) and in measures of gastroesophageal reflux (p<0.001).

In the 15 infants with 24-hour pH monitoring data, the authors saw a significant drop in reflux index from 5.2 at baseline to 2.47 after 1 week (p < 0.001).

The babies used the beds for an average of 3.2 months, until they outgrew them.

Although medication discontinuation "was not an endpoint of this pilot study," the researchers point out, "all medication could be successfully stopped in more than half of the patients."

"Considering this experience," the team concludes, "the MC AR-Bed needs to be evaluated in a larger series of infants prior to pharmacological treatment in infants presenting with frequent regurgitation and reflux-associated symptoms."

The authors developed the bed in collaboration with Peos (Ninove, Belgium), which now sells the product. Although the estimated purchase cost is 1000 euros, the researchers suggest the bed could be rented from pharmacies for only 1.75 euros per day.

Arch Dis Child 2010;95:26-30.

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