European Journal of Pediatrics

, Volume 149, Issue 9, pp 608–612 | Cite as

Observations on gastro-oesophageal reflux, central apnoea and heart rate in infants

  • J. Y. Paton
  • C. S. Nanayakkara
  • H. Simpson


Respiratory movements and heart rate were monitored continuously during the course of 2 h radionuclide studies to detect gastro-oesophageal reflux (GOR) in 22 infants following a milk feed. Twenty infants had GOR, to upper oesophageal/pharyngeal level in 19, and 17 had central apnoea between 3 and 15 s. Prolonged central apnoea (> 20s) was not observed. Bradycardia, defined as a heart rate less than 80 beats/min for 10 s or more, was observed in only 1 infant who did not have GOR. No correlation was found between the number or duration of reflux episodes and the frequency of respiratory pauses between 3 and 17 s. When data from individual infants were examined a possible temporal relation between the occurrence of GOR and central apnoea was seen in only two infants; in each case, detailed examination suggested that apnoea was more closely associated with sleep than with GOR. Although the respiratory monitoring system did not include airflow sensors, the almost complete absence of bradycardia suggested that prolonged obstructive apnoeas did not occur. We conclude that any relation between GOR and central apnoeas<15 s is not of a direct cause/effect nature.

Key words

Gastro-oesophageal reflux Central apnoea Bradycardia Sudden infant death 



apparently life threatening effects


gastro-oesophageal reflux


lower quartile


upper quartile


Sudden infant death


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ariagno RL, Guilleminault C, Baldwin R, Owen-Boeddiker M (1982) Movement and gastroesophageal reflux in awake term infants with ‘near miss’ SIDS, unrelated to apnea. J Pediatr 100:894–897PubMedGoogle Scholar
  2. 2.
    Herbst JJ, Book LS, Bray PF (1978) Gastroesophageal reflux in the ‘near miss’ sudden infant death syndrome. J Pediatr 92:73–75PubMedGoogle Scholar
  3. 3.
    Herbst JJ, Minton SD, Book LS (1979) Gastroesophageal reflux causing respiratory distress and apnea in newborn infants. J Pediatr 95:763–768PubMedGoogle Scholar
  4. 4.
    Heyman S, Kirkpatrick JA, Winter HS, Treves S (1979) An improved radionuclide method for the diagnosis of gastroesophageal reflux and aspiration in children (Milk scan). Radiology 131:479–482PubMedGoogle Scholar
  5. 5.
    Jefferey HE, Rahilly P, Read DJC (1983) Multiple causes of asphyxia in infants at high risk for sudden infant death. Arch Dis Child 58:92–100PubMedGoogle Scholar
  6. 6.
    Leape LL, Holder TM, Franklin JD, Amoury RA, Ashcraft KW (1977) Respiratory arrest in infants secondary to gastro-oesophageal reflux. Pediatrics 60:924–928PubMedGoogle Scholar
  7. 7.
    MacFadyen UM, Hendry GMA, Simpson H (1983) Gastro-oesophageal reflux in near-miss sudden infant death syndrome or suspected recurrent aspiration. Arch Dis Child 58:87–91PubMedGoogle Scholar
  8. 8.
    MacFadyen UM, Borthwick G, Simpson H, McKay M, Neilson J (1988) Monitoring for central apnoea in infancy-limitations of single channel recordings. Arch Dis Child 63:282–287PubMedGoogle Scholar
  9. 9.
    Mason S (1962) Some aspects of gastric function in the newborn. Arch Dis Child 37:387–391PubMedGoogle Scholar
  10. 10.
    Menon AP, Schefft GL, Thach BT (1985) Apnea associated with regurgitation in infants. J Pediatr 106:625–629PubMedGoogle Scholar
  11. 11.
    Paton JT, Cosgriff PS, Nanayakkara CS (1985) The analytical sensitivity to Tc99m radionuclide ‘milk’ scanning in detection of gastro-oesophageal reflux. Pediatr Radiol 15:381–383PubMedGoogle Scholar
  12. 12.
    Seibert JJ, Byrne WJ, Euler AR, Latture T, Leach M (1983) Gastroesophageal reflux—the acid test: scintigraphy or the pH probe. AJR 140:1087–1090PubMedGoogle Scholar
  13. 13.
    Spitzer AR, Boyle JT, Tuckman DN, Fox WW (1984) Awake apnea associated with gastroesophageal reflux: a specific clinical syndrome. J Pediatr 104:200–205PubMedGoogle Scholar
  14. 14.
    Walsh JK, Farrel MK, Keenan WJ, Lucas M, Kramer M (1981) Gastroesophageal reflux in infants: relation to apnea. J Pediatr 99:197–201PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • J. Y. Paton
    • 1
  • C. S. Nanayakkara
    • 1
  • H. Simpson
    • 1
  1. 1.Department of Child HealthUniversity of LeicesterLeicesterUK

Personalised recommendations