Skip to main content

Gastro-oesophageal reflux: A mixed methods study of infants admitted to hospital in the first 12months following birth in NSW (2000-2011).

Dahlen, H., Foster, J., Psaila, K, Spence, K, Badawi, N, Fowler, C, Schmied, V and Thornton, C, 2018. Gastro-oesophageal reflux: A mixed methods study of infants admitted to hospital in the first 12months following birth in NSW (2000-2011). BMC Pediatrics, 18 (1).

Full text available as:

[img]
Preview
PDF
s12879-022-07628-4 (1).pdf

7MB

DOI: 10.1186/s12887-018-0999-9

Abstract

Background: Gastro-oesophageal reflux (GOR) is common in infants. When the condition causes pathological symptoms and/or complications it is considered gastro-oesophageal reflux disease (GORD). It appears to be increasingly diagnosed and causes great distress in the first year of infancy. In New South Wales (NSW), residential parenting services support families with early parenting difficulties. These services report a large number of babies admitted with a label of GOR/GORD. The aim of this study was to explore the maternal and infant characteristics, obstetric interventions, and reasons for clinical reporting of GOR/GORD in NSW in the first 12months following birth (2000-2011). Methods: A three phase, mixed method sequential design was used. Phase 1 included a linked data population based study (n=869,188 admitted babies). Phase 2 included a random audit of 326 medical records from admissions to residential parenting centres in NSW (2013). Phase 3 included eight focus groups undertaken with 45 nurses and doctors working in residential parenting centres in NSW. Results: There were a total of 1,156,020 admissions recorded of babies in the first year following birth, with 11,513 containing a diagnostic code for GOR/GORD (1% of infants admitted to hospitals in the first 12months following birth). Babies with GOR/GORD were also more likely to be admitted with other disorders such as feeding difficulties, sleep problems, and excessive crying. The mothers of babies admitted with a diagnostic code of GOR/GORD were more likely to be primiparous, Australian born, give birth in a private hospital and have: a psychiatric condition; a preterm or early term infant (37-or-38weeks); a caesarean section; an admission of the baby to SCN/NICU; and a male infant. Thirty six percent of infants admitted to residential parenting centres in NSW had been given a diagnosis of GOR/GORD. Focus group data revealed two themes: "It is over diagnosed" and "A medical label is a quick fix, but what else could be going on?" Conclusions: Mothers with a mental health disorder are nearly five times as likely to have a baby admitted with GOR/GORD in the first year after birth. We propose a new way of approaching the GOR/GORD issue that considers the impact of early birth (immaturity), disturbance of the microbiome (caesarean section) and mental health (maternal anxiety in particular). © 2018 The Author(s).

Item Type:Article
ISSN:1471-2431
Additional Information:Cited By :18 Export Date: 7 September 2022 CODEN: BPMEB Correspondence Address: Dahlen, H.G.; Western Sydney University, Locked Bag 1797, Australia; email: h.dahlen@westernsydney.edu.au Funding text 1: The authors would like to acknowledge the funding provided by the above listed institutions and the assistance provided by the staff at Tresillian and Karitane. This study is part of an Australian Research Linkage Grant. Funding text 2: This study is part of a larger study funded by the Australian Research Council to examine the physical, psychological and demographic characteristics, trends, service needs and co-admissions to other health services of women admitted to residential parenting services (RPS) of Tresillian and Karitane in NSW from 2000 to 2011. There is a tiered system of health services in Australia providing maternal and child health support, including, non-psychiatric day stay and residential parenting services (RPS) such as Tresillian and Karitane (in NSW). Funding text 3: Funding was provided by an Australian Research Council Partnership grant between Western Sydney University, Tresillian and Karitane. References: Omari, T., Barnett, C., Benninga, M., Lontis, R., Goodchild, L., Haslam, R., Dent, J., Davidson, G., Mechanisms of gastro-oesophageal reflux in preterm and term infants with reflux disease (2002) Gut, 51 (4), pp. 475-479; Vandenplas, Y., Rudolph, C.D., Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the north American Society for Pediatric Gastroenterology, hepatology, and nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, hepatology, and nutrition (ESPGHAN) (2009) J Pediatr Gastroenterol Nutr, 49, pp. 498-547; Salvatore, S., Vandenplas, Y., Gastroesophageal reflux and cows milk allergy: is there a link? (2002) Pediatrics, 110 (5), pp. 972-984; Machado, R., Woodley, F.W., Skaggs, B., Di Lorenzo, C., Splaingard, M., Mousa, H., Gastroesophageal relux causing sleep interruptions in infants (2013) J Pediatr Gasttoenterology Nutr, 56 (4), pp. 431-435; Willmott, A., Murphy, M.S., Gastro-esophageal reflux (2004) Curr Paediatr, 14, pp. 586-592; Vandenplas, Y., Rudolph, C.D., Pediatric Gasroesophageal reflux clinical practice guidelines: joint recommendations of the north American Society for Pediatric Gastroenterology, Heapatology, and nutrition (NASPGHAN) and the European Society for Peditric Gstroenterology, Heaptology, and nutrition (ESPGHAN) (2009) J Pediatr Gastroenterol Nutr, 49, pp. 498-547; Neu, M., Corwin, E., Lareau, S.C., Marcheggiani-Howard, C., A review of nonsurgical treatment for the symptom of irritability in infants with GERD (2012) J Spec Pediatr Nursing, 17 (3), pp. 177-192; Ammari, M., Djeddi, D., Leke, A., Delanaud, S., Stephan-Blanchard, E., Bach, V., Telliez, F., Relationship between sleep and acid gastroe-oesophageal reflux in neonates (2012) J Sleep Res, 21, pp. 80-86; Field, D., Garland, M., Williams, K., Correlates of specific childhood feeding problems (2003) J Pediatr Child Health, 39 (4), pp. 299-304; Hawdon, J.M., Beauregard, N., Slattery, J., Kennedy, G., Identification of neonates at risk of developing feeding problems in infancy (2000) Dev Med Child Neurol, 42 (4), pp. 235-239; Woodley, F.W., Hayes, J., Mousa, H., Acid gastroesophageal reflux in symptomatic infants is primarily a function of classic 2-phase and pH-only acid reflux event types (2009) J Pediatr Gastroenterol Nutr, 48 (5), pp. 550-558; Heine, R.G., Jordan, B., Lubitz, L., Meehan, M., Catto-Smith, A.G., Clinical predictors of pathological gastro-oesophageal reflux in infants with persistent distress (2006) J Pediatr Child Health, 42 (3), pp. 134-139; Vandenplas, Y., Hassall, E., Mechanisms of gastrooesophageal reflux and gastroesophageal reflux disease (2002) J Pediatr Gastroenterol Nutr, 35 (2), pp. 119-136; Dogra, H., Lad, B., Sirisena, D., Paediatric gastro-oesophageal reflux disease (2011) British J Med Pract, 4 (2), p. 412; Ramirez, A., Wong, W., Shulman, R., Factors regulating gastric emptying in preterm infants (2006) J Pediatr, 149, pp. 475-479; (2002) J Pediatr Gastroenterol Nutr, 32, pp. S16-S18; Peter, C.S., Wiechers, C., Bohnhorst, B., Silny, J., Poets, C.F., Influence of nasogastric tubes on gastroesophageal reflux in preterm infants: a multiple intraluminal impedance study (2002) J Pediatr, 141, pp. 277-279; Eisen, G., The epidemiology of gastroesophageal reflux disease: what we know and what we need to know (2001) Eisen GM, 96, pp. S16-S18; Iacono, G., Merolla, R., D'Amico, D., Bonci, E., Cavataio, F., Scalici, C., Indinnimeo, L., Carroccio, A., Gastrointestinal symptoms in infancy: a population-based prospective study (2005) Dig Liver Dis, 37 (6), pp. 432-438; Nelson, S.P., Chen, E.H., Syniar, G.M., Christoffel, K.K., Prevalence of symptoms of gastroesophageal reflux during infancy. A pediatric practice-based survey (1997), 151, pp. 569-572. , In: Archives of Pediatric and Adolescent Medicine. Edited by group.PPR; Miyazawa, R., Tomomasa, T., Kaneko, H., Tachibana, A., Ogawa, T., Morikawa, A., Prevalence of gastro-esophageal reflux-related symptoms in Japanese infants (2002) Pediatr Int, 44, pp. 513-516; Martin, M., Pratt, N., Kennedy, D., Ryan, P., Ruffin, R., Miles, H., Marley, J., Natural history and familial relationships of infant spilling to 9 years of age (2002) Pediatrics, 109 (6), pp. 1061-1067; DiPietro, J.A., Cusson, R.M., O'Brien Caughy, M., Fox, N.A., Behavioral and physiologic effects of non-nutritive sucking during gavage feeding in preterm infants (1994) Pediatr Res, 236 (2), pp. 207-2014; Wenzi, T., Silny, J., Schenke, S., Peschgens, T., Heimann, G., Skopnik, H., Gastroesophageal reflux and respiratory phenomena in infants: status of the intraluminal impedance technique (1999) J Pediatr Gastroenterolo Nutrition, 28 (4), pp. 423-428; DeVault, K.R., Castell, D.O., Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease (2005) Am J Gastroenterol, 100 (1), pp. 190-200; (2015), In. Edited by Excellence NIfHaC: National Collaborating Centre for Women's and Children's Health; Psaila, K., Foster, J., (2015) Critically Ill Infants with Gastro-Oesophageal Reflux, 1, pp. 859-870. , In: Rajendram R, Preedy VR, Patel VB, editors. diet and Nutrition in Critical Care, edn. New York: Springer; Fisher, J., Rowe, H., Building an Evidence Base for Practice in Early Parenting Centers (2004) A Systematic Review of the Literature and a Report of an Outcome Study, 2004. , In. Melbourne: Key Centre for Women's Health in Society, School of Population Health, University of Melbourne; Rowe, H.J., Fisher, J.R.W., The contribution of Australian residential early parenting centres to comprehensive mental health care for mothers of infants: evidence from a prospective study (2010) Int J Ment Heal Syst, 4; Cresswell, J., Plano Clark, V., (2011) Choosing a Mixed Methods Design, p. 11. , In: Cresswell J, Plano Clark V, editors. Designing and Conducting Mixed Methods Research. 2nd edn. Thousand Oaks: Sage; Johnson, R.B., Onwuegbuzie, A.J., Mixed methods research: a research paradigm whose time has come (2004) Educ Res, 33 (7), pp. 14-26; Shannon-Baker, P., Making paradigms meaningful in mixed methods research (2015) J Mixed Methods Res, pp. 1-16; Feilzer, M.Y., Doing mixed methods research pragmatically: implications for the rediscovery ofPragmatism as a research paradigm (2010) J Mixed Methods Res, 4, p. 6; (2012), 2014. , http://www.cherel.org.au/media/24160/qareport2012.pdf; Fowler, C., Schmied, V., Dickinson, M., Dahen, H.G., Working with complexity: experiences of caring for mothers seeking residential parenting services in new South Wales, Australia (2016) J Clin Nurs, 26 (3-4), pp. 524-534; Creswell, J., Klassen, A., Plano Clark, V., Clegg Smith, K., (2011) Best practices for mixed methods research in the health sciences in, , Edited by Research OoBaSS. New England: National Institute of Health; Newell, S.J., Sarkar, P.K., Durbin, G.M., Booth, I.W., McNeish, A.S., Maturation of the lower oesophageal sphincter in the preterm baby (1988) Gut, 29, pp. 167-172; Boix-Ochoa, J., Canals, J., Maturation of the lower esophagus (1976) J Pediatr Surg, 11 (5), pp. 749-756; Gupta, A., Jadcherla, S.R., The Relationship Between Somatic Growth and In Vivo Esophageal Segmental and Sphincteric Growth in Human Neonates (2006), 43 (1), pp. 35-41; Pena, E.M., Parks, V.N., Peng, J., Fernandez, S.A., Di Lorenzo, C., Shaker, R., Jadcherla, S.R., Lower esophageal sphincter relaxation reflex kinetics: effects of peristaltic reflexes and maturation in human premature neonates (2010) Am J Physiol Gastrointest Liver Physiol, 23; Kawahara, H., Dent, J., Davidson, G., Mechanisms responsible for gastroesophageal reflux in children (1997) Gastroenterology, 113, pp. 399-408; Dahlen, H., Tracy, S., Tracy, M.B., Bisits, A., Brown, C., Thornton, C., Rates of obstetric intervention and associated perinatal mortality and morbidity among low-risk women giving birth in private and public hospitals in NSW (2000-2008): a linked data population-based cohort study (2014) BMJ Open, 4. , https://doi.org/10.1136/bmjopen-2013-004551; (2015) AIoH: Australia's mothers and babies 2013-in brief, , In: Perinatal statistics series. Canberra: AIHW; Cheong, J.L., Doyle, L.W., Increasing rates of prematurity and epidemiology of late preterm birth (2012) J Paediatr Child Health, 48 (9), pp. 784-788; Bhutani, V.K., Stark, A.R., Lazzeroni, L.C., Poland, R., Gourley, G.R., Kazmierczak, S., Meloy, L., Stevenson, D.K., Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy (2013) J Pediatr, 162 (3), pp. 477-482; Reddy, U.M., Ko, C.W., Willinger, M., Early term births (37-38 weeks) are associated with increased mortality (2006) Am J Obstet Gynecol, 195; Tracy, S., Tracy, M., Sullivan, E., Admission of term infants to neonatal intensive care: a population-based study (2007) Birth, 34 (4), pp. 301-307; Tracy, S.K., Tracy, M.B., Sullivan, E., Admission of term infants to neonatal intensive care: a population-based study (2007) Birth, 34 (4), pp. 301-307; Adams-Chapman, I., Insults to the developing brain and impact on neurode- velopmental outcome. Journal of communication disorders (2009) J Commun Disord, 42, pp. 256-262; Osowicki, J., Gewee, A., Noronha, J., Britton, P.N., Isaacs, D., Lai, T.B., Nourse, C., Francis, J.R., Australia-wide point prevalence survey of antimicrobial prescribing in neonatal units how much and how good? (2015) Pediatr Infect Dis J, 34 (8), pp. e185-e190; Stensballe, L.G., Simonsen, J., Jensen, S.M., Bonnelykke, K., Bisgaard, H., Use of Antibiotics during Pregnancy Increases the Risk of Asthma in Early Childhood (2013) J Pediatr, 162 (4), pp. 832-838; Collier, C.H., Risnes, K., Norwitz, E.R., Bracken, M.B., Illuzzi, J.L., Maternal infection in pregnancy and risk of asthma in offspring (2013) Maternal Child Health Journal; Metsälä, J., Lundqvist, A., Virta, L.J., Kaila, M., Gissler, M., Virtanen, S.M., Mother's and Offspring's use of antibiotics and infant allergy to Cow's milk (2013) Epidemiology, 24 (2), pp. 303-309; Ajslev, T.A., Andersen, C.S., Gamborg, M., Sørensen, T.I.A., Jess, T., Childhood overweight after establishment of the gut microbiota: the role of delivery mode, pre-pregnancy weight and early administration of antibiotics (2011) Int J Obes, 35, pp. 522-529; Azad, M.B., Konya, T., Maughan, H., Guttman, D.S., Field, C.J., Chari, R.S., Sears, M.R., Kozyrskyj, A.L., Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months (2013) Can Med Assoc J; Cardwell, C.R., Stene, L.C., Joner, G., Cinek, O., Svensson, J., Goldacre, M.J., Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies (2008) Diabetologia, 51, pp. 726-735; Thavagnanam, S., Fleming, J., Bromley, A., Shields, M.D., Cardwell, C.R., A meta-analysis of the association between Caesarean section and childhood asthma (2008) Clin Exp Allergy, 38, pp. 629-633; Hyde, M.J., Mostyn, A., Modi, N., Kemp, P.R., The health implications of birth by caesarean section (2012) Biol Rev, 87 (1), pp. 229-243; Azad, M.B., Konya, T., Persaud, R.R., Guttman, D.S., Chari, R.S., Field, C.J., Sears, M.R., Subbarao, P., Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study (2015) BJOG, , Online Sept 2015; Indrio, F., Di Mauro, A., Riezzo, G., Civardi, E., Intini, C., Corvaglia, L., Ballardini, E., Brazzoduro, E., Prophylactic use of probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial (2014) JAMA Pediatr, 168 (3), pp. 228-233; Havranek, T., Al-Hosni, M., Armbrecht, E., Probiotics supplementation increases intestinal blood flow velocity in extremely preterm infants (2013) J Perinatol, 33, pp. 40-44; Indrio, F., Riezzo, G., Raimondi, F., Bisceglia, M., Cavallo, L., Francavilla, R., The effects of probiotics on feeding tolerance, bowel habits, and gastrointestinal motility in preterm newborns (2008) J Pediatr, 152, pp. 801-806; Yamasaki, C., Totsu, S., Uchiyama, A., Nakanishi, H., Masumoto, K., Washio, Y., Shuri, K., Kusuda, S., Effect of bifidobacterium administration on very-low-birthweight infants (2012) Pediatr Int, 54, pp. 651-656; Garofoli, F., Civardi, E., Indrio, F., Mazzuchelli, I., Angelini, M., Tinelli, C., Stronati, M., The early administration of lactobacillus reuteri DSM 17938 controls regurgitation episodes in full-term breastfed infants (2014) Int J Food Sci Nutr, 65 (5), pp. 646-648; Indrio, F., Di Mauro, A., Riezzo, G., Civardi, E., Intini, C., Corvaglia, L., Ballardini, E., Brazzoduro, E., (2014) JAMA Pediatr, 168 (3), pp. 228-233; Indrio, F., Reizzo, G., Raimondi, F., Bisceglia, M., Filannino, A., Cavallo, L., Francavilla, R., Lactobacillus reuteri accelerates gastric emptying and improves regurgitation in infants (2011) Eur J Clin Investig, 41 (4), pp. 417-422; Christl, B., Reilly, N., Smith, M., Sims, D.G., Chavasse, F., Austin, M.P., The mental health of mothers of unsettled infants: is there value in routine psychosocial assessment in this context? (2013) Arch Womens Mental Health, 16, pp. 391-399; McMahon, C., Barnett, B., Kowalenko, N., Tennant, C., Don, N., Postnatal depression, anxiety and unsettled infant behaviour (2001) Aust N Z J Psychiatry, 35, pp. 581-588; Radesky, J.S., Zuckerman, B., Siverstein, M., Rivara, F.P., Barr, M., Taylor, J.A., Lengua, L.J., Barr, R.G., Inconsolable infant crying and maternal postpartum epressive symptoms (2013) Pediatrics, 131 (6), pp. e1857-e1864; Petzoldt, J., Wittchen, H.U., Einsle, F., Martini, J., Maternal anxiety versus depressive disorders: specific relations to infants' crying, feeding and sleeping problems (2015) Child Care Health Dev; Petzoldt, J., Maternal anxiety disorders predict excessive infant crying: a prospective longitudinal study (2014) Arch Dis Child, 99, pp. 800-806; Postert, C., Averbeck-Holocher, M., Arhtergarde, S., Muller, J.M., Furniss, T., Regulatory disorders in early childhood: correlates in child behavior, parent-child relationship, and parental mental health (2013) Infant Mental Health Journal, 33, pp. 173-186; Bolten, M., Infant psychiatric disorders (2013) Eur Child Adolesc Psychiatry, 22, pp. S69-S74; Karacetin, G., Demir, T., Erkan, T., Cokugras, F.C., Sonmez, A.B., Maternal psychopathology and psychomotor development of children with GERD (2011) JPGN, 53 (4), pp. 380-385; Vaiserman, A.M., The developmental origins of health and disease hypothesis which suggests early environmental factors influence mental and physical health into adulthood has been described (2015) Dev Dyn, 244, pp. 254-265; Schmid, G., Wolke, D., Preschool regulatory problems and attention-deficit/hyperactivity and cognitive deficits at school age in children born at risk: different phenotypes of dysregulation? (2014) Early Hum Dev, 90, pp. 399-405; Hegar, B., Dewanti, N.R., Kadim, M., Alatas, S., Firmansyah, A., Vandenplas, Y., Natural evolution of regurgitation in healthy infants (2009) Acta Paediatr, 98 (7), pp. 1189-1193; Fike, F., Mortellaro, V.E., Pettiford, M.P., Ostlie, D.J., Diagnosis of gastroesophageal reflux disease in infants (2011) Pediatr Surg Int, 27, pp. 791-797; Lightdale, J.R., Gremse, D.A., Gastroesophageal reflux: management guidance for the pediatrician (2013) Pediatrics, 131 (5), pp. e1684-e1895; Quitadamo, P., Papadopoulou, A., Wenzl, T., Urbonas, V., Kneepkens, C.M.F., Roman, E., Orel, R., Vandenplas, Y., European pediatricians' approach to children with GER symptoms: survey of the implementation of 2009 NASPGHAN-ESPGHAN guidelines (2014) J Pediatr Gastroenterol Nutr, 58 (4), pp. 505-509; Bialek-Gieruszczak, D., Konarska, Z., Skorka, A., No effect of proton pump inhibitors on crying and irritability in infants: systematic review of randomized controlled trials (2015) J Pediatr, 166, pp. 767-770; Orenstein, S.R., Hassall, E., Furmaga-Jablonska, W., Atkinson, S., Raanan, M., Multi-centre, double-blind randomized placebo-controlled trial assessing the efficacy of proton pump inhibitor lansoprazole in infants with symptoms of gastroesophageal reflux disease (2009) J Pediatr, 154, pp. 514-520; van der Pol, R., Smits, M.J., Venmans, L., Boluyt, N., Benninga, M.A., Tabbers, M.M., Diagnostic accuracy of tests in pediatric gastroesophageal reflux disease (2013) J Pediatr, 162 (5), pp. 983-987; Verhage, M.L., Oosterman, M., Schuengel, C., The linkage between infant negative temperament and parenting self-efficacy: the role of resilience against negative performance feedback (2015) Br J Dev Psychol, 33, pp. 506-518; Lightdale, J.R., Gremse, D.A., Section on gastroenterology, hepatology and nutrition. Gastroesophageal relux: management guidance for the pediatrician (2013) Pediatrics, 131, pp. e1684-e1695; Verhage, M.L., Oosterman, M., Schuengel, C., The linkage between infant negative temperament and parenting self-efficacy: The role of resilience against negative performance feedback (2015) British J Dev Psychol, 33, p. 506; Meijer, A.M., van den Wittenboer, G.L.H., Contribution of infants' sleep and crying to marital relationships of first-time parent couples in the 1st year after childbirth (2007) J Fam Psychol, 21, pp. 49-57; Jordan, B., Heine, R.G., Meehan, M., Catto-Smith, A.G., Lubitz, L., Effect of antireflux medication, placebo and infant mental health intervention on persistent crying: a randomized clinical trial (2006) J Paediatr Child Health, 42, pp. 49-58; Petzoldt, J., Wittchen, H.U., Einsle, F., Martini, J., Maternal anxiety versus depressive disorders: specific relations to infants' äô crying, feeding and sleeping problems (2015) Child Care Health Dev Background: Gastro-oesophageal reflux (GOR) is common in infants. When the condition causes pathological symptoms and/or complications it is considered gastro-oesophageal reflux disease (GORD). It appears to be increasingly diagnosed and causes great distress in the first year of infancy. In New South Wales (NSW), residential parenting services support families with early parenting difficulties. These services report a large number of babies admitted with a label of GOR/GORD. The aim of this study was to explore the maternal and infant characteristics, obstetric interventions, and reasons for clinical reporting of GOR/GORD in NSW in the first 12months following birth (2000-2011). Methods: A three phase, mixed method sequential design was used. Phase 1 included a linked data population based study (n=869,188 admitted babies). Phase 2 included a random audit of 326 medical records from admissions to residential parenting centres in NSW (2013). Phase 3 included eight focus groups undertaken with 45 nurses and doctors working in residential parenting centres in NSW. Results: There were a total of 1,156,020 admissions recorded of babies in the first year following birth, with 11,513 containing a diagnostic code for GOR/GORD (1% of infants admitted to hospitals in the first 12months following birth). Babies with GOR/GORD were also more likely to be admitted with other disorders such as feeding difficulties, sleep problems, and excessive crying. The mothers of babies admitted with a diagnostic code of GOR/GORD were more likely to be primiparous, Australian born, give birth in a private hospital and have: a psychiatric condition; a preterm or early term infant (37-or-38weeks); a caesarean section; an admission of the baby to SCN/NICU; and a male infant. Thirty six percent of infants admitted to residential parenting centres in NSW had been given a diagnosis of GOR/GORD. Focus group data revealed two themes: "It is over diagnosed" and "A medical label is a quick fix, but what else could be going on?" Conclusions: Mothers with a mental health disorder are nearly five times as likely to have a baby admitted with GOR/GORD in the first year after birth. We propose a new way of approaching the GOR/GORD issue that considers the impact of early birth (immaturity), disturbance of the microbiome (caesarean section) and mental health (maternal anxiety in particular). © 2018 The Author(s).
Uncontrolled Keywords:Caesarean section;Diagnosis;Gastro-oesophageal reflux;GOR;GORD;Mental health;adult;anxiety;Article;cesarean section;child parent relation;clinical audit;cohort analysis;controlled study;crying;diagnostic error;feeding difficulty;female;gastroesophageal reflux;hospital admission;human;infant;major clinical study;male;New South Wales;pediatrics;primipara;sex difference;sleep disorder;gastroesophageal reflux;health service;hospitalization;information processing;maternal behavior;mental disease;microflora;newborn;pathophysiology;physiology;prematurity;psychology;Adult;Anxiety;Cesarean Section;Female;Focus Groups;Gastroesophageal Reflux;Hospitalization;Humans;Infant;Infant, Newborn;Infant, Premature;Maternal Behavior;Medical Overuse;Mental Disorders;Microbiota;New South Wales
Group:UNSPECIFIED
ID Code:37459
Deposited By: Symplectic RT2
Deposited On:07 Sep 2022 10:21
Last Modified:07 Sep 2022 10:21

Downloads

Downloads per month over past year

More statistics for this item...
Repository Staff Only -