Evaluating the reflux suppression properties of Gaviscon Infant powder with different milk formulations using an in vitro model of the infant stomach.

Gastroesophageal reflux (GER) is common in babies and infants and is characterized by effortless regurgitation (with or without vomiting), which is a common symptom of other infant conditions, including cow's milk protein allergy (CMPA). Various milk formulations are commercially available to help manage GER and CMPA symptoms (extensively hydrolyzed [eHF], partially hydrolyzed [pHF], and amino-acid formulas [AAF]). We aimed to understand if an alginate product (Gaviscon Infant powder) worked as intended in the presence of different milk formulations. A previously evaluated artificial infant stomach model simulated an internal pressure-inducing reflux event (five reflux events performed at 5 min intervals). Suppression activity of Gaviscon Infant combined with eHF, pHF, and AAF was assessed by measuring the height that the refluxate event traveled up a tube mimicking the infant esophagus, alongside a benchmark unhydrolyzed formulation (uHF) with Gaviscon Infant and a negative control without Gaviscon Infant. Each experiment was repeated six times per formulation in a random order. Gaviscon Infant combined with each milk formulation produced a lower height of refluxate versus the negative control. When formulations combined with Gaviscon Infant were grouped by category (eHF, pHF, AAF), two or more products from each category showed a lower refluxate height than the benchmark (uHF). There was a significant difference in median refluxate height (p = 0.0011 in Wilcoxon rank sum test) when comparing Gaviscon Infant combined with eHF against Gaviscon Infant combined with pHF, AAF, or uHF (benchmark). Refluxate height did not change significantly between events one and five for each milk formulation combined with Gaviscon Infant. In an artificial infant stomach model, Gaviscon Infant combined with different milk formulations (uHF, eHF, pHF, AAF) produced a lower refluxate height compared with a negative control (uHF without Gaviscon Infant), suggesting that Gaviscon Infant suppresses reflux as intended when used with different milk formulations.