Patient/Parent/Guardian Education

Positional Modifications

• Infants should be kept in an upright position during feeding
• Infants & children should be fully awake when ingesting food
• Semi-supine positioning for at least 2 hours after food ingestion may help reduce reflux-related respiratory events
• Supine positioning during sleep is recommended

Obesity

• Weight loss should be considered in older obese children
• Studies have shown improvement in pH profiles in children who lost weight

Smoking & Alcohol

• Smoking cessation & avoidance of alcohol intake is strongly encouraged adolescents
• Exposure to secondhand smoke also increases irritability in infants & should be avoided

Dietary changes

• May consider switching to milk formula that contains extensively hydrolyzed protein or amino acid-based formula instead of regular formulas
• Maternal diet modification is encouraged for mothers of breastfeeding infants
  
  • Avoidance of egg & milk intake may be considered  

• Thickeners (thickening agent, rice cereals) may be considered in healthy formula-fed infants but should be used with caution especially in preterm infants at increased risk for necrotizing enterocolitis
• May try small, frequent feedings instead of one big meal while ensuring appropriate total daily amount of nutrition
• Eating before bedtime should be avoided
• Food that may trigger symptoms in adolescents (eg caffeine, carbonated drinks, chocolate, mint-containing food, spicy food) should be avoided