Transpyloric feeding in gastroesophageal-reflux-associated apnea in premature infants

Objective: The aetiological role of gastroesophageal reflux in apnea of prematurity is controversial. We hypothesized that transpyloric feeds, which decreases reflux and aspiration, will not be associated with decrease in reflux-related apnea. Study design: The shows retrospective chart review of 41 premature babies on transpyloric feeds. Fifteen infants meeting the inclusion criteria of apnea of prematurity and clinical evidence of gastroesophageal reflux were included. Primary data points were number of apneas before and after transpyloric feeds. t-statistics was used for analysis. Results: Twelve of the 15 babies showed significant improvement on transpyloric feeds (p <. 005). The nonresponders were identified within 48 h. After discontinuation of transpyloric feeds, 2 responders underwent antireflux surgery and 9 were discharged without further intervention. No transpyloric-tube-related complication was documented. Conclusion: Transpyloric feeds may be useful for diagnosis and management of suspected gastroesophageal-reflux-associated apnea in a selected group of infants.