Continuous Feedings are Not Associated with Lower Rates of Gastroesophageal Reflux When Compared to Bolus Feedings.

Abstract

Gastroesophageal reflux disease is common in children with gastrostomy tubes. Clinicians often transition to continuous feedings in an attempt to reduce reflux burden, though there is limited data to support this practice. In this retrospective study, we analyzed 24-hour multichannel intraluminal impedance with pH studies in 18 children with gastrostomy tubes receiving exclusive enteral nutrition with a combination of daytime bolus and overnight continuous feedings. There were no significant differences in the rate of reflux (reflux events per hour) between no feeding, bolus feeding and continuous feeding periods overall or stratified by prior fundoplications (p > 0.40). After adjusting for age, BMI, feeding rate and feeding volume in multivariate analysis, there were no significant differences in the risk of reflux between different feeding periods. These results suggest that continuous feedings may not offer a significant advantage in reducing reflux burden.