{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:01:42Z","timestamp":1790254902946,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We compared the direct effects of routine vs rice\u2010thickened formula on 24\u2010h pH\u2010impedance and symptom characteristics and then examined if dietary effects were modified by acid reflux index severity in infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty infants under consideration for gastroesophageal reflux disease and therapies were evaluated at 43\u2009\u00b1\u20091 weeks postmenstrual age. Each infant was equally fed routine diet and thickened formula during evaluations. Postprandial sessions were analyzed for acid reflux index, reflux events, clearance times, distal baseline impedance, and symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thickened formula has no effect (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2265\u20090.05) on acid reflux events\u2019 characteristics or overall symptom frequency. However, refluxate height and frequency of weakly acidic events and cough were decreased (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Prolonged bolus clearance and a decrease in distal baseline impedance were noted with thickened feeds (vs routine feeds) when acid reflux index was &gt;7 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our pH\u2010impedance testing protocol identifies direct effects of potential therapies at the point of care. Acutely, thickened formula does not impact acid\u2010specific reflux indices but decreases full\u2010column reflux and cough reflexes. In those with an acid reflux index of &gt;7, thickened formula prolongs the distal esophageal bolus clearance (the mechanisms of which are uncertain). Clinical trials are needed to clarify objective indications and therapeutic use of thickened formulas for infants with gastroesophageal reflux disease, along with short\u2010 and long\u2010term side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpen.2566","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T07:04:26Z","timestamp":1697612666000},"page":"64-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of direct effects of rice\u2010thickened formula vs routine feeds on symptoms and gastroesophageal reflux indices: A crossover cohort study"],"prefix":"10.1002","volume":"48","author":[{"given":"Minna","family":"Njeh","sequence":"first","affiliation":[{"name":"Innovative Feeding Disorders Research Program, The Abigail Wexner Research Institute Nationwide Children's Hospital Columbus Ohio 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