What is the initial therapy for a 3-week-old infant with symptoms of gastroesophageal reflux disease?

The initial therapy for a 3-week-old infant experiencing symptoms of gastroesophageal reflux disease (GERD) typically involves non-pharmacological interventions focused on feeding practices and positioning. The most effective initial strategy is to implement smaller, more frequent feedings while holding the infant upright. This approach helps to minimize the volume of milk in the stomach at any one time, reducing the likelihood of reflux occurring. Additionally, holding the infant after feedings can help to keep stomach contents down due to gravity, further mitigating reflux symptoms.

Feeding in smaller amounts allows for easier digestion and reduces the pressure on the lower esophageal sphincter, which is important in preventing the backflow of stomach contents into the esophagus. This method is particularly suitable for infants, whose anatomical structures are still developing.

Other options may include various postures and timing of feedings, but they are either less effective or not appropriate for such a young infant. For example, rotating formulas or changing positions might not specifically address the underlying issue of reflux as effectively as changing feeding strategies.