Regurgitation in infants, also known as possetting, is a normal physiological process that occurs several times a day, usually following feeds. Infant feeding problems can occur when reflux and regurgitation of stomach contents occurs repeatedly and for excessive periods (lasting over five minutes). Approximately 18% of infants have episodes of symptomatic reflux and it can occur in both breast and bottle-fed babies. It peaks at around four to six months of age and usually resolves by twelve to fourteen months.¹⁴ The pharmacy team is well placed to offer advice and guidance to concerned parents and to refer onwards for investigation of symptoms if necessary.

Some definitions:

Regurgitation

• Also known as possetting
• It is the passage of refluxed gastric contents from the oesophagus into the pharynx and mouth
• Sometimes expelled out of the mouth
• Effortless and non-projectile

Gastro-oesophageal reflux (GOR)

• The passage of gastric contents into the oesophagus
• Can occur with or without regurgitation
• Is a normal physiological process in infants (and adults)
• Occurs when the lower oesophageal sphincter does not fully close
• In infants the sphincter is not fully matured and has a weak action

Gastro-oesophageal reflux disease (GORD)

• When the reflux of gastric contents occurs excessively and causes troublesome symptoms and/or results in complications including oesophagitis, apnoea, faltering growth and anaemia
• GORD in infants can be a result of cow's milk protein allergy

¹⁴ Falconer J. How to manage reflux in infants: Journal of Family Health Care. Col. 22 No. 4. RD. https://www.aptamilprofessional.co.uk/pharmacy-learning-modules.