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Published in: Pediatric Radiology 5/2020

01-05-2020 | Scintigraphy | Original Article

Gastric emptying of milk in infants and children up to 5 years of age: normative data and influencing factors

Authors: Neha S. Kwatra, Eglal Shalaby-Rana, Mary P. Andrich, Jason Tsai, Amy L. Rice, Sunil J. Ghelani, Stephanie E. Spottswood, Massoud Majd

Published in: Pediatric Radiology | Issue 5/2020

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Abstract

Background

Gastric emptying scintigraphy is widely used in infants and children, but there is a lack of age-specific normative data.

Objective

The objectives of this retrospective study were: 1) to establish a range of gastric emptying of milk or formula as a surrogate for normal gastric emptying in infants and young children ≤5 years of age, and 2) to investigate the effects of patient age, feeding volume, feeding route and gastroesophageal reflux on gastric emptying.

Materials and methods

The reports of 5,136 gastric emptying studies of children ≤5 years of age performed at Children’s National Medical Center from January 1990 to August 2012 were reviewed. Demographic data, 1-h and 3-h gastric emptying values and gastroesophageal reflux status of all patients were stored in a database. Using stringent inclusion and exclusion criteria, the studies of patients as similar to healthy children as possible were selected for this study.

Results

The study group included 2,273 children (57% male) ages 0–59 months (median: 4.6 months). The median 1-h gastric emptying was 43% (interquartile range [IQR] 34–54%). The median 3-h gastric emptying was 91% (IQR 79–98%). Sixty-one percent of patients with 1-h gastric emptying value of <50% had 3-h gastric emptying ≥80%. Gastric emptying was significantly faster in children ≤6 months as compared with all older age groups. In each age group, the median gastric emptying decreased with increasing feeding volume. Gastric emptying was significantly faster in patients fed via combined nasogastric tube and oral routes as compared with those fed exclusively orally. There was no significant difference in gastric emptying of children with and without gastroesophageal reflux.

Conclusion

Although there are statistically significant differences in gastric emptying based on age, volume and route of feeding, the data suggest that overall normal liquid gastric emptying in infants and children ≤5 years of age is ≥80% at 3 h. One-hour emptying measurements are not reliable for detecting delayed gastric emptying.
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Metadata
Title
Gastric emptying of milk in infants and children up to 5 years of age: normative data and influencing factors
Authors
Neha S. Kwatra
Eglal Shalaby-Rana
Mary P. Andrich
Jason Tsai
Amy L. Rice
Sunil J. Ghelani
Stephanie E. Spottswood
Massoud Majd
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Keyword
Scintigraphy
Published in
Pediatric Radiology / Issue 5/2020
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-020-04614-3

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