Quality standard
Quality statement 1: Information about gastro‑oesophageal reflux (GOR) in infants
Quality statement 1: Information about gastro‑oesophageal reflux (GOR) in infants
Quality statement
Parents and carers attending postnatal appointments are given information about gastro‑oesophageal reflux (GOR) in infants.
Rationale
Regurgitation of feeds in infants can cause anxiety for parents and carers. Providing information about GOR can reassure parents and carers that, in well infants, effortless regurgitation of feeds is a common and normal occurrence that affects at least 40% of infants and is likely to resolve before the infant is 1.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that parents and carers attending postnatal appointments are given information about GOR in infants.
Data source: Local data collection.
Process
Proportion of infants aged 8 weeks and under whose parents or carers received information about GOR during 1 of the postnatal appointments.
Numerator – the number in the denominator whose parents received information about GOR during 1 of the postnatal appointments.
Denominator – the number of infants aged 8 weeks and under who had at least 1 postnatal appointment.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers (community care trusts, secondary care trusts, specialised women's/maternity providers) ensure that postnatal appointments include providing information about GOR in infants.
Healthcare professionals (health visitors, midwives, paediatric nurses or GPs) give information to parents and carers attending postnatal appointments about GOR in infants.
Commissioners (clinical commissioning groups, local authorities) ensure that postnatal appointments are commissioned to provide information about GOR in infants.
Parents and carers attending postnatal appointments receive information about reflux (regurgitating, bringing up or vomiting feeds) in babies.
Source guidance
Gastro-oesophageal reflux disease in children and young people. NICE guideline NG1 (2015, updated 2019), recommendation 1.1.3 (key priority for implementation) and 1.1.4
Definitions of terms used in this quality statement
Gastro-oesophageal reflux (GOR)
GOR is the passage of gastric contents into the oesophagus. It is a common physiological event that can happen at all ages from infancy to old age, and is often asymptomatic. It occurs more frequently after feeds/meals. In many infants, reflux is associated with a tendency to 'overt regurgitation' – the visible regurgitation of feeds. [NICE's guideline on gastro-oesophageal reflux disease in children and young people]
Information for people attending postnatal appointments
Information should explain that in well infants, effortless regurgitation of feeds:
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is very common (it affects at least 40% of infants)
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usually begins before the infant is 8 weeks old
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may be frequent (5% of infants affected have 6 or more episodes each day)
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usually becomes less frequent with time (it resolves in 90% of affected infants before they are 1 year old)
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does not usually need further investigation or treatment.
[NICE's guideline on gastro-oesophageal reflux disease in children and young people, recommendation 1.1.3 (key priority for implementation) and 1.1.4]