NICE stepwise recommendations on infant regurgitation

Functional gastrointestinal issues are common in infancy¹. For example, around 30% of infants below one year of age will experience regurgitation¹. This can be a distressing and confusing time for parents, who may not be confident in what to change or adapt to help their baby keep down their feed.

For first-line management of breast-fed infants who present with frequent regurgitation and marked distress, NICE recommends a breastfeeding assessment is carried out by a person with appropriate expertise or training.

For formula-fed infants NICE have developed a stepped-care approach²:

1. Review the feeding history
2. Reduce the feed volumes only if excessive for the infant’s weight
3. Offer a trial of smaller, more frequent feeds – while maintaining the advised daily intake of milk (unless the feeds are already small and frequent)
4. Offer a trial of a thickened formula (that contains rich starch, cornstarch, locust bean gum or carob bean gum)