Did Symptoms Improve?

1. Is the infant growing?

  • Weight gain of 10-20 grams/kg/day
  • Maintaining or improving growth curve

2. Has the infant's behavior during feedings improved?

  • Able to comfortably ingest prescribed amounts of formula within 20-30 minutes.
  • Aversive behaviors such as crying, arching, gagging, choking, and nipple avoidance have decreased.
  • Episodes of bradycardia and desaturation associated with feedings have decreased. 

3. Has the pattern of vomiting changed?

  • Vomiting episodes are less painful.
  • Frequency and amount of emesis or regurgitation into posterior pharynx have decreased.

4. Has the frequency of recurrent illness changed?

  • Episodes of respiratory set back (increased oxygen needs, increased work of breathing) will decrease in severity as developmentally appropriate.

5. How is the family and care giver coping with the infant's GER?

  • Feeding time is relaxed for infant and care giver.
  • Caregiver is able to administer medications effectively.

Consensus: Dept of Neonatology. CMH&C.


These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.

 

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