Reflux and regurgitation
Managing the symptoms of reflux and regurgitation can be challenging. We’ve gathered the latest guidelines and expert opinions to support healthcare professionals to make the correct diagnosis and help to reduce concern among parents. Click on each of the tabs below to learn more about infant reflux and regurgitation and to download resources.
Rome IV Diagnostic Criteria3
Must include both of the following, in otherwise healthy infants, 3 weeks to 12 months of age:
- Regurgitation 2+ times per day for 3+ weeks
- Without the presence of retching, hematemesis, aspiration, apnoea, failure to thrive, feeding or swallowing difficulties, or abnormal posturing
Research indicates that reflux reaches its peak around 4 months and begins to resolve by 7 months although some infants may have symptoms up to 12 months.1,3 Every infant will vary in this.
ESPGHAN Guidelines on Management4
EAACI Review of Pharmacological Management5
- No guideline recommends the use of prokinetic agents
- ESPGHAN4 found insufficient evidence to recommend a trial with an alginate
- H2RAs do not reduce crying/distress or visible regurgitation/vomiting and have limited evidence on efficacy and safety
- Concerns that PPIs impact the long-term bioavailability of certain vitamins/minerals and increase the risk of developing food allergy
Breastfeeding is best for infants. Instant Carobel is a food for special medical purposes for the dietary management of habitual and recurrent vomiting, and rumination. It should only be used under medical supervision, after full consideration of the feeding options available including breastfeeding. Suitable for full term infants, children and adults. It is not suitable for use as the sole source of nutrition. For enteral use only.