Feed thickener for newborn infants with gastro-oesophageal reflux

There is no current evidence from randomised trials to show that adding feed thickeners to milk for newborn infants is effective in treating gastro-oesophageal reflux. Many newborn babies (in the first four weeks of life) suffer from gastro-oesophageal reflux, especially if they are born premature. Thickening the milk feed is a simple manoeuvre and commonly used as first line treatment for gastro-oesophageal reflux. Thickening the feeds can be used with or without other treatments such as positioning babies on their stomach or side, and using medications that suppress acid in the stomach or cause food to move more rapidly through the stomach. No randomised controlled studies of sufficient quality were found in this review. Therefore, there is no current evidence to support or refute the use of feed thickeners in treating newborn babies with gastro-oesophageal reflux.

Authors' conclusions: 

There is no evidence from randomised controlled trials to support or refute the efficacy of feed thickeners in newborn infants with GOR. Given the absence of evidence, we cannot recommend using thickening agents for management of GOR in newborn infants.

Read the full abstract...

Gastro-oesophageal reflux (GOR) is common in newborn infants. A common first line management is the use of feed thickeners.


In newborn infants with GOR, to evaluate the use of feed thickeners in reducing signs and symptoms of GOR, acid episodes on pH monitoring and histological evidence of oesophagitis.

Search strategy: 

We searched MEDLINE from 1966 to March 2004, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2004). CINAHL from 1982 to December 2001, and conference and symposia proceedings published in Pediatric Research 1990 to 1994. We also searched conference proceedings for the European Society for Paediatric Gastroenterology and Nutrition (ESPGAN) and the North American Society for Pediatric Gastroenterology and Nutrition (NASPGAN) from 1994 to December 2001. We did not restrict the searches to the English language.

Selection criteria: 

All randomised controlled trials that examine the effects of thickening formulas on treating gastro-oesophageal reflux in neonates. The eligible studies were to compare thickened feeds to no intervention (unthickened feeds).

Data collection and analysis: 

Two independent reviewers identified potential studies from the literature search. Quality was independently assessed by two independent reviewers.

Main results: 

No studies fulfilled the requirements for inclusion in the systematic review.