***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND & AIMS Nasogastric feeding may result in gastro-oesophageal reflux and , therefore , increase the risk of aspiration . This may be greater when feeds are administered via a bolus than by infusion . We aim ed to measure gastric emptying time and quantify gastro-oesophageal reflux in healthy volunteers given a liquid feed via an oral bolus ( OB ) , a nasogastric tube bolus ( TB ) and a nasogastric tube drip ( TD ) . METHODS Twelve male volunteers participated in three separate studies ( OB , TB and TD ) in r and om order , each 3 days apart . The feed consisted of 220 ml Ensure Plus ( 1.5 kcal/ml ) , labelled with 12 MBq (99m)Tc DTPA . The OB and TB were given over 5 min and the infusion rate for the TD was 55 ml/h . Gastric emptying time was measured using gamma scintigraphy . Gastro-oesophageal reflux was observed continuously until the stomach was empty , using a multichannel intraluminal impedance catheter . RESULTS Mean ( 95 % CI ) T(50 ) gastric emptying times for the OB and TB studies were 41.3 ( 36.5 - 46.2 ) min and 36.2 ( 30.6 - 41.8 ) min respectively ( p=0.19 ) . The stomach emptied at a rate equal to the infusion rate in the TD studies . Median ( IQR ) number of reflux episodes for the OB , TB and TD studies were 4.5 ( 2.0 - 6.0 ) , 3.0 ( 2.0 - 4.75 ) and 2.0 ( 0.25 - 6.25 ) respectively . Median ( IQR ) total duration of reflux for the OB , TB and TD studies were 38 ( 20 - 242 ) , 49 ( 17 - 71 ) and 36 ( 1 - 125 ) s respectively ( p = NS ) . CONCLUSIONS The lack of difference in gastro-oesophageal reflux between bolus and continuous feeding indicates that in healthy volunteers both methods are equally safe with respect to the risk of aspiration BACKGROUND Nearly 90 - 95 % of children with drool have physiologic gastroesophageal reflux ( GER ) that usually resolves by 12 - 15 months of age ; however , 5 - 10 % of children with drool have pathologic GER . Of these children , most recover clinical ly by 18 months of age without therapy , yet 10 % develop chronic , recurrent gastroesophageal reflux disease ( GERD ) with sequelae . The respiratory symptoms associated with GER consist mainly of bronchial asthma and laryngospasm , but often include a persistent cough of unknown aetiology , obstructive apnoea , and an obstructive respiratory syndrome confined to the nasopharynx . Gastric acid reflux , enters the adenoids , causes oedema of the tubal orifices , and later leads to relapsing diseases of the middle ear in children . AIM AND SCOPE To evaluate the incidence of otologic manifestations in children with GER and the efficacy of treatment , comparing two different groups of children ( i.e. , treated versus untreated ) . SUBJECTS AND METHODS From January 2005 to November 2006 , audiologic screening of newborns and suckling children ( 0 - 24 months of age ) at risk for auditory illnesses was held at the University Department of Otolaryngology in Catania . Seventy-three children ( average age , 13 months ) were selected after failing acoustic otoemissions for chronic bilateral catarrhal pathology involving the middle ear ( tympanometry type B ) and were positive for at least one of the different signs of GER at the time of history-taking . The children were r and omised and subdivided into two groups : ( 1 ) a group of 40 children ( 27 females and 13 males ; average age , 12 months ) who received treatment ; and ( 2 ) a group of 29 children ( 16 males and 13 females ; average age , 14 months ) who did not receive treatment . Four children were lost to follow-up after completing the study . All children enrolled in the study underwent a rhinopharynxlaryngeal fibroscopy with flexible optics , a gastric ultrasound scan after clinical observation , and a multi-channel pH-metry for 18 - 24h . RESULTS Findings obtained by rhinopharynxlaryngeal fibroscopy showed that 82 % of cases had diffuse hyperaemia involving the entire rhinopharyngeal mucosa and 13 % of the cases had arytenoidal hyperaemia . Resolution and improvement of the reflux occurred in 52.5 and 40 % of the cases in the treated group , respectively , versus complete resolution and an improvement in symptoms of 45 and 30 % of cases , respectively , in the control group . CONCLUSIONS The hypothesis of a correlation between reflux and chronic middle otitis of the serous-mucous type was confirmed in the present study . Adopting a preventive treatment strategy may be useful in reducing the possibility of ear involvement We compared two feeding regimens , continuous intragastric feedings and intermittent oral feeding , in nine infants with protracted diarrhea and malnutrition and two infants with surgically created short bowel . Continuous nasogastric feeding caused significant increases in enteral balance of the major nutrients , whereas intermittent feedings result ed in negative or only slightly positive enteral balance . The improvements in enteral balance from intermittent to continuous feeding in infants with diarrhea were as follows : Fat from 13 + /- 0.8 to 22 + /- 2.0 gm/24 hours ; nitrogen from 0.63 + /- 0.2 to 1.7 + /- 0.2 gm/24 hours ; calcium from -63 + /- 20 to 145 + /- 4 mg/24 hours ; zinc from -0.57 + /- 0.2 to 1.3 + /- 0.2 mg/24 hours ; and copper from -0.09 + /- 0.03 to 0.21 + /- 0.02 mg/24 hours . There was also a significant increase in body weight during the continuous feeding ( 168 + /- 16 gm/72 hours ) as compared to the intermittent feeding ( -171 + /- 26 gm/72 hours ) . Similar improvements in enteral balance were seen in the two infants with short bowel . These findings document that improved enteral balance can be achieved with continuous feeding in infants with bowel disease Nutritional benefits and feeding-related complications were prospect ively compared in 53 preterm very-low-birth-weight infants receiving isoenergetic feeding by either the continuous nasogastric ( n = 30 ) or intermittent nasogastric ( n = 23 ) route . Stepwise regression techniques were used to develop models relating feeding-associated factors . Feeding method significantly affected weight gain in infants 1000 to 1249 g birth weight with continuous nasogastric feeding associated with an additional weight gain of 3.6 to 6.1 g/kg/d . No effects of feeding method on changes in occipitofrontal circumference , triceps skin-fold thickness , bilirubin values , or total protein values were demonstrable . There were few major differences between feeding groups on measures of feeding complications . Continuous nasogastric feeding was fairly well tolerated and result ed in improved weight gain when compared with intermittent nasogastric feeding in preterm infants 1000 to 1249 g birth weight OBJECTIVE To compare the effects of continuous versus intermittent feeding on gastrointestinal tolerance and growth in very low birth weight ( VLBW ) infants . STUDY DESIGN In a r and omized , controlled trial conducted at 3 neonatal units , 70 premature infants with a gestational age 24 to 29 weeks and birth weight < 1200 g were assigned to 1 of 3 feeding methods : continuous nasogastric feeding , intermittent nasogastric feeding , or intermittent orogastric feeding . Feeding was initiated within 30 hours of birth . Daily enteral and parenteral volumes , caloric and protein intakes , growth , enteral intolerance , and clinical complications were recorded . Cox regression analysis was used to determine primary outcome , the time to achieve full enteral feeding . RESULTS The continuously fed infants achieved full enteral feeding significantly faster than the intermittently fed infants ( hazard ratio [ HR ] = 1.86 ; 95 % confidence interval [ CI ] = 1.07 to 3.22 ) . In stratified analysis according to birth weight , the improvement was even more pronounced in the smallest infants , those with birth weight < or = 850 g ( adjusted HR = 4.13 ; 95 % CI = 1.48 to 11.53 ) . Growth rate was significantly faster in the continuously fed infants ( P = .002 ) . CONCLUSION In VLBW infants , continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance and growth Purpose : The aim of our study was to evaluate the relationship between gastric emptying and gastroesophageal reflux ( GER ) in infants and children . Methods and Material s : One hundred eight patients ( pts ) between 3 months and 5 years of age ( 77 boys , 31 girls ) with clinical suspicion of GER disease were included in the study . Patients were divided into 2 groups according to the age range : group A , 0–2 years ( 57 pts ) , and group B , 2–5 ( 51 pts ) years . Each group was divided into 2 subgroups according to the scintigraphic study as GER-positive and -negative . Cow 's milk with Tc-99 m sulfur colloid as radiotracer was used . Gastric emptying was expressed as the half emptying time ( T1/2 ) . The detection of activity in the esophagus at any time during scintigraphy was considered an indicator of GER episodes . Reflux episodes were grade d as grade 1 if activity was detected on one or 2 frames and grade 2 if activity was detected on more than 2 frames . Results : Forty of the 108 patients ( 37 % ) had GER findings on scintigraphy . The comparison of gastric emptying time between positive GER scintigraphy and negative GER scintigraphy groups was not statistically significant in any age group . No association was found between age and rate of gastric emptying time . Although the comparison of T1/2 between grade 1 patients and the GER-negative group was not statistically significant , grade 2 patients showed significant differences and had prolonged gastric emptying times . Mild statistical correlation between the number of reflux episodes and gastric emptying half time was found . Conclusions : As a conclusion , the relation between gastroesophageal reflux and delayed gastric emptying can not be ignored . Our results support delayed gastric emptying to be a pathogenetic factor in gastroesophageal reflux in infants and children The increased survival of sick and preterm neonates may be associated with long‐term problems which must be recognised and managed if outcome is to be optimised . In a prospect i ve study of 35 neonates ( median gestational age at birth 34 weeks ) admitted to a neonatal intensive care unit over a 3‐month period , we have documented a high incidence ( 14 of 35 ) of immature or abnormal feeding patterns when infants were assessed at 36 to 40 weeks postmenstrual age . Neonates with  prolonged respiratory support and delayed enteral and oral feeding were most affected . Compared with neonates who have normal initial feeding assessment s , neonates with disorganised or dysfunctional feeding were six times more likely to vomit and three times more likely to cough when offered solid food at 6 months of age . At 12 months of age significant differences were also found in tolerating lumpy food and enjoying mealtimes . We hypothesise that these feeding problems contribute to failure to thrive and psychosocial distress after discharge from the neonatal unit and propose potential neonatal measures to reduce their incidence The National Institute of Child Health and Human Development conducts and supports research on all stages of human development from preconception to adulthood in order to better underst and the health of children , youths , adults , families , and communities . Health and human development information is made easily available on the site with a simple A to Z list , along with clinical trials and health education campaign information . Links to clinical trials , news releases , publications , and related web sites are also available , as well as information on research being conducted at present and supported by the National Institute of Child Health and Human Development OBJECTIVE To assess the efficacy of omeprazole in treating irritable infants with gastroesophageal reflux and /or esophagitis . STUDY DESIGN Irritable infants ( n=30 ) 3 to 12 months of age met the entry criteria of esophageal acid exposure > 5 % ( n=22 ) and /or abnormal esophageal histology ( n=15 ) . They completed a 4-week , r and omized , double-blind , placebo-controlled crossover trial of omeprazole .  Cry/fuss diary ( minutes/24 hours ) and a visual analogue scale of infant irritability as judged by parental impression were obtained at baseline and the end of each 2-week treatment period . RESULTS The reflux index fell significantly during omeprazole treatment compared with placebo ( 
    Output:
    
We did not identify any r and omised trials that evaluated the effects of continuous versus intermittent bolus intragastric tube feeding on  gastro-oesophageal reflux disease in preterm and low birth weight infants .