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THE EFFECTS OF GASTROESOPHAGEAL REFLUX ON INFANT CAREGIVING PRACTICES AND DEVELOPMENT.

Pediatric Physical Therapy: April 2004 - Volume 16 - Issue 1 - p 61
doi: 10.1097/01.PEP.0000115221.39160.D5
Section Information: Abstracts of Poster and Platform Presentations for the 2004 Combined Sections Meeting: Poster Presentations
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THE EFFECTS OF GASTROESOPHAGEAL REFLUX ON INFANT CAREGIVING PRACTICES AND DEVELOPMENT.

M. Mandich, L.J. Freed, S.G. Holderman, L.M. McClelland, T.A. Quinlan, Division of Physical Therapy, West Virginia University, Morgantown, WV, S.K. Ritchie, S. Lynch, Department of Pediatrics, West Virginia University, Morgantown, WV.

PURPOSE/HYPOTHESIS: The purpose of the present study was to examine the relationship between positioning, gastroesophageal reflux disease (GERD) and motor development in preterm infants.

NUMBER OF SUBJECTS: The subjects were 22 preterm infants. Eligibility criteria were gestational age of less than or equal to 37 weeks and an adjusted age of 2–6 months.

MATERIALS/METHODS: A correlational design was used to determine the relationship between study variables, including infant characteristics, parental report of caregiving, health care provider assessment and motor development as measure by the Alberta Infant Motor Scale (AIMS). Data were analyzed descriptively as well as by simple and multiple linear regression techniques.

RESULTS: Descriptive statistics showed the most frequent sleeping position was supine; the most frequent awake position was supported sitting. The swing was the most frequently utilized piece of infant equipment. There was a slight trend for total AIMS score to be negatively impacted by presence of severe reflux. Results of the multiple linear regression showed: birth weight (+) and time in bassinette (-) were significant predictors of AIMS total score; awake position (-) and adjusted age (+) were significant predictors of AIMS prone score; time in bassinette (-) was a significant predictor of AIMS supine score; birth weight (+), adjusted age (+), reflux now (+), reflux worst by physician (-) and sleep position (-) were significant predictors of AIMS sitting score.

CONCLUSIONS: The study results confirm other reports that infant caregiving practices impact motor development in the first year, at least transiently. Fear of SIDS and infant preference tended to be the most common reason for positioning, rather than avoidance of spitting. Presence of severe reflux was negatively correlated to total AIMS score. The most common awake position was supported sitting and the most common equipment was the swing, crib and car seat. This confirmed that contemporary infant caregiving practices limit the amount of time infants spend in prone. Further investigation of these findings is warranted.

CLINICAL RELEVANCE: Physical therapists are often consulted about infants at risk for developmental delay. In recognizing the multiple systems that impact motor development, including physiological and environmental, therapists may better educate parents about positioning and caregiving practices which facilitate normal motor development.

© 2004 Lippincott Williams & Wilkins, Inc.