Positioning
Holding the infant in a head-elevated position for 20-30 minutes after feeding may reduce GERD (Farivar, 2001). The prone position has also been shown to reduce reflux, aspiration, and crying time and speed gastric emptying (Sherman, 2001). According to Borowitz (2002), after meals, the best position to place a baby with reflux is lying prone with the head of the bed raised about 30 degrees. Parents should be cautioned that placing the infant in a prone position should only be done when the child is awake and can be continuously observed. Prone positioning during sleep is only considered in unusual cases where the risk of death from complications of GER outweighs the potential increased risk of SIDS (Rudolph et al., 2001). The semi-supine position after feeding, such as when placing the baby in an infant car seat, exacerbates GER and should be avoided (Rudolph et al., 2001; Sandritter, 2003).
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