Prevalence of Symptoms of Gastroesophageal Reflux During Infancy: A Pediatric Practice-Based Survey

Abstract

OBJECTIVES: To determine the prevalence of symptoms associated with overt gastroesophageal reflux (GER) during the first year of life, to describe when most infants outgrow these symptoms, and to assess the prevalence of parental reports of various symptoms associated with GER and the percentages of infants who have been treated for GER. DESIGN: Cross-sectional survey. SETTING: Nineteen Pediatric Practice Research Group practices in the Chicago, Ill, area (urban, suburban, and semirural). PARTICIPANTS: A total of 948 parents of healthy children 13 months old and younger. INTERVENTION: None. MAIN OUTCOME MEASURE: Reported frequency of regurgitation. RESULTS: Regurgitation of at least 1 episode a day was reported in half of 0- to 3-month-olds. This symptom decreased to 5% at 10 to 12 months of age (P < .001). Peak reported regurgitation was 67% at 4 months; the prevalence of symptoms decreased dramatically from 61% to 21% between 6 and 7 months of age. Infants with at least 4 episodes daily of regurgitation showed a similar pattern (P < .001). Peak regurgitation reported as a "problem" was most often seen at 6 months (23%); this prevalence decreased to 14% at 7 months of age. Parental perception that regurgitation was a problem was associated with the frequency and volume of regurgitation, increased crying or fussiness, reported discomfort with spitting up, and frequent back arching. Reported treatment for regurgitation included a change in formula in 8.1%, thickened feedings in 2.2%, termination of breast-feeding in 1.1%, and medication in 0.2%. CONCLUSIONS: Complaints of regurgitation are common during the first year of life, peaking at 4 months of age. Many infants "outgrow" overt GER by 7 months and most by 1 year. Parents view this symptom as a problem more often than medical intervention is given.