A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?
a. Surgical therapy is indicated.
b. Place in prone position for sleep after feeding.
c. Thicken feedings and enlarge the nipple hole.
d. Reduce the frequency of feeding by encouraging larger volumes of formula.
ANS: C
Thickened feedings decrease the child's crying and increase the caloric density of the feeding. Although it does not decrease the pH, the number and volume of emesis are reduced. Surgical therapy is reserved for children who have failed to respond to medical therapy or who have an anatomic abnormality. The prone position is not recommended because of the risk of sudden infant death syndrome. Smaller, more frequent feedings are more effective than less frequent, larger volumes of formula.
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