Preventing the Use of Anti-Reflux Medication in Infants Diagnosed with Cleft Palate through Lifestyle Interventions

Background: Gastroesophageal reflux is a highly prevalent condition in infants, particularly those with a cleft lip or palate. Children with cleft lip or palate are much more likely to be treated with an anti-reflux medication than the general population of infants. While anti-reflux medication is indicated for infants with certain comorbidities (failure to thrive, esophagitis), it is not a first line treatment for gastroesophageal reflux. Lifestyle interventions can be used to treat reflux and may prevent anti-reflux medication use. Methods: A quality improvement project was developed to help increase the knowledge of gastroesophageal reflux management in parents of children with cleft lip or palate and providers treating these children. An evidence-based educational toolkit was developed for parents to provide education regarding lifestyle interventions used for reflux. Additionally, a toolkit was developed to provide education for providers regarding the management of reflux, including when anti-reflux medications were indicated. Post-education surveys were given to parents and providers to evaluate the effectiveness of the education. Results: Post-intervention, the study found that 82% of parents (n=9) identified that the toolkit gave them alternative ways to treat reflux without medication. Additionally, 100% (n=5) of providers indicated the toolkit was appropriate for the clinic. 80% (n=4) of providers reported they learned the indications for appropriate treatment of reflux with medications. No anti-reflux medication was prescribed during the three months following implementation of the toolkit (January-March 2022). Conclusions: The educational toolkit appears to be a valuable resource to help increase knowledge of gastroesophageal reflux treatment amongst parents and providers. Additional studies are needed to evaluate the effectiveness of the education in a larger sample size.