Aim Regurgitation and feeding related infant distress is a frequent cause for consult.
Material and Methods A “AR-bed” was developed in a pilot study in about 20 infants. The system allows infants to “hang” in 40° supine position. We tested the efficacy of this bed in 25 babies (3 weeks-3 months old) with frequent regurgitation and inconsolable crying, in which dietary treatment (extensive hydrolysate, AR-formula) and medication (domperidone, H2RA, PPI) had been unsuccessful. The parents filled in a diary (frequency of regurgitation, crying time, time asleep, “overall sleep comfort” on a 1-10 scale) during 2 days (baseline) and during 1 week intervention. An oesophageal pH monitoring was performed before inclusion and after 7 days in 10 infants.
Results 8/25 parents stopped the intervention within 2 days, because the infant’s crying increased or bended over (32% failure). 17/25 parents were satisfied (sleep comfort (median): “3” before inclusion to “8” after one week). The incidence of regurgitation decreased. The reflux index (% time pH was <4.0 in the oesophagus) was 18.6% (median 14.1; range 2.1–52.5) at inclusion and 10.1% (median 7.1; range 32.5–0.5) after 1 week (p: 0.008 Wilcoxon-test).
Conclusion The Multicare-Mattress® seems effective in the majority of a group of infants presenting with persistent crying and frequent regurgitation not responding to reflux medication and dietary treatment. A significant decrease of oesophageal acid exposure is demonstrated. The Multicare-Mattress® can be considered especially in infants in whom history suggests a time relation between feeding, regurgitation and distress.