The breath hydrogen test is used in gastroenterological investigation, particularly for sugar malabsorption, transit time, and the investigation of small-bowel bacterial overgrowth. Several methods of collecting breath from infants and children for hydrogen assay have been described. Four such techniques (postnasal catheter, nasal prong, Rahn-Otis end-tidal sampler, and modification of a party toy--the 'Wiggins's blowout') were compared with breath collection using the Haldane-Priestley tube. Multiple sampling of breath from 3 adults was performed after initial lactulose loads to increase breath hydrogen excretion. The variability between the different assay techniques was less than the inherent variability of repeated breath hydrogen assays using the same technique. Each technique is therefore adequate for breath hydrogen collection; we recommend the Rahn-Otis end-tidal sampler in young infants and children, and the Haldane-Priestley tube in older children, since these were most acceptable to the children and their parents.
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