Premature infants with frequent regurgitation and postprandial desaturation (n = 22) underwent a 24-hour recording of MII-pH. In a within-subjects design, reflux indexes were analyzed with the infants in 4 different positions: supine (S), prone (P), on the right side (RS), and on the left side (LS).
All infants were analyzed for 20 hours. The mean number of recorded GER episodes was 109.7. The mean esophageal exposure to acid and nonacid GER was lower in positions P (4.4 % and 0.3 % , respectively) and LS (7.5 % and 0.7 % , respectively) than in positions RS (21.4 % and 1.2 % , respectively) and S (17.6 % and 1.3 % , respectively). The number of postprandial nonacid GER episodes decreased but the number of acid GER episodes increased over time. The LS position showed the lowest esophageal acid exposure (0.8 % ) in the early postprandial period, and the P position showed the lowest esophageal acid exposure (5.1 % ) in the late postprandial period.
Placing premature infants in the prone or left lateral position in the postprandial period is a simple intervention to limit GER.