Skip to main content
SpringerLink
Log in

Gastric emptying of milk in infants and children up to 5 years of age: normative data and influencing factors

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Gastric emptying scintigraphy is widely used in infants and children, but there is a lack of age-specific normative data.

Objective

The objectives of this retrospective study were: 1) to establish a range of gastric emptying of milk or formula as a surrogate for normal gastric emptying in infants and young children ≤5 years of age, and 2) to investigate the effects of patient age, feeding volume, feeding route and gastroesophageal reflux on gastric emptying.

Materials and methods

The reports of 5,136 gastric emptying studies of children ≤5 years of age performed at Children’s National Medical Center from January 1990 to August 2012 were reviewed. Demographic data, 1-h and 3-h gastric emptying values and gastroesophageal reflux status of all patients were stored in a database. Using stringent inclusion and exclusion criteria, the studies of patients as similar to healthy children as possible were selected for this study.

Results

The study group included 2,273 children (57% male) ages 0–59 months (median: 4.6 months). The median 1-h gastric emptying was 43% (interquartile range [IQR] 34–54%). The median 3-h gastric emptying was 91% (IQR 79–98%). Sixty-one percent of patients with 1-h gastric emptying value of <50% had 3-h gastric emptying ≥80%. Gastric emptying was significantly faster in children ≤6 months as compared with all older age groups. In each age group, the median gastric emptying decreased with increasing feeding volume. Gastric emptying was significantly faster in patients fed via combined nasogastric tube and oral routes as compared with those fed exclusively orally. There was no significant difference in gastric emptying of children with and without gastroesophageal reflux.

Conclusion

Although there are statistically significant differences in gastric emptying based on age, volume and route of feeding, the data suggest that overall normal liquid gastric emptying in infants and children ≤5 years of age is ≥80% at 3 h. One-hour emptying measurements are not reliable for detecting delayed gastric emptying.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Abell TL, Camilleri M, Donohoe K et al (2008) Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Am J Gastroenterol 103:753–763

    Article  Google Scholar 

  2. Hauser B, Roelants M, De Schepper J et al (2016) Gastric emptying of liquids in children. J Pediatr Gastroenterol Nutr 62:403–408

    Article  Google Scholar 

  3. Singh SJ, Gibbons NJ, Blackshaw PE et al (2006) Gastric emptying of solids in normal children—a preliminary report. J Pediatr Surg 41:413–417

    Article  Google Scholar 

  4. Hauser B, Roelants M, De Schepper J et al (2016) Gastric emptying of solids in children: reference values for the (13) C-octanoic acid breath test. Neurogastroenterol Motil 28:1480–1487

    Article  CAS  Google Scholar 

  5. Malik R, Srivastava A, Gambhir S et al (2016) Assessment of gastric emptying in children: establishment of control values utilizing a standardized vegetarian meal. J Gastroenterol Hepatol 31:319–325

    Article  Google Scholar 

  6. Knatten CK, Avitsland TL, Medhus AW et al (2013) Gastric emptying in children with gastroesophageal reflux and in healthy children. J Pediatr Surg 48:1856–1861

    Article  Google Scholar 

  7. Montgomery M, Escobar-Billing R, Hellström PM et al (1998) Impaired gastric emptying in children with repaired esophageal atresia: a controlled study. J Pediatr Surg 33:476–480

    Article  CAS  Google Scholar 

  8. Gelfand MJ, Wagner GG (1991) Gastric emptying in infants and children: limited utility of 1-hour measurement. Radiology 178:379–381

    Article  CAS  Google Scholar 

  9. Seibert JJ, Byrne WJ, Euler AR (1983) Gastric emptying in children: unusual patterns detected by scintigraphy. AJR Am J Roentgenol 141:49–51

    Article  CAS  Google Scholar 

  10. Rosen PR, Treves S (1984) The relationship of gastroesophageal reflux and gastric emptying in infants and children: concise communication. J Nucl Med 25:571–574

    CAS  PubMed  Google Scholar 

  11. Di Lorenzo C, Piepsz A, Ham H, Cadranel S (1987) Gastric emptying with gastro-oesophageal reflux. Arch Dis Child 62:449–453

    Article  Google Scholar 

  12. Chen W, Codreanu I, Yang J et al (2013) Tube feeding increases the gastric-emptying rate determined by gastroesophageal scintigraphy. Clin Nucl Med 38:962–965

    Article  Google Scholar 

  13. Hillemeier AC, Lange R, McCallum R et al (1981) Delayed gastric emptying in infants with gastroesophageal reflux. J Pediatr 98:190–193

    Article  CAS  Google Scholar 

  14. Aktaş A, Ciftçi I, Caner B (1999) The relation between the degree of gastro-oesophageal reflux and the rate of gastric emptying. Nucl Med Commun 20:907–910

    Article  Google Scholar 

  15. Argon M, Duygun U, Daglioz G et al (2006) Relationship between gastric emptying and gastroesophageal reflux in infants and children. Clin Nucl Med 31:262–265

    Article  Google Scholar 

  16. Katz M (2006) Study design and statistical analysis: a practical guide for clinicians. Cambridge University, New York

    Book  Google Scholar 

  17. Schmitz A, Kellenberger CJ, Lochbuehler N et al (2012) Effect of different quantities of a sugared clear fluid on gastric emptying and residual volume in children: a crossover study using magnetic resonance imaging. Br J Anaesth 108:644–647

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Boston Children’s Hospital, Boston, MA, USA

    Neha S. Kwatra

  2. Division of Diagnostic Imaging and Radiology, Children’s National Medical Center, 111 Michigan Ave., N.W., Washington, DC, 20010, USA

    Eglal Shalaby-Rana, Mary P. Andrich & Massoud Majd

  3. Department of Radiology, Good Samaritan Hospital Medical Center, West Islip, NY, USA

    Jason Tsai

  4. Independent consultant (biostatistics), Chevy Chase, MD, USA

    Amy L. Rice

  5. Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA

    Sunil J. Ghelani

  6. Department of Radiology, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, USA

    Stephanie E. Spottswood

  7. Radiology and Pediatrics, The George Washington University, Washington, DC, USA

    Massoud Majd

Authors
  1. Neha S. Kwatra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eglal Shalaby-Rana
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mary P. Andrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jason Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amy L. Rice
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sunil J. Ghelani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stephanie E. Spottswood
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Massoud Majd
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Massoud Majd.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kwatra, N.S., Shalaby-Rana, E., Andrich, M.P. et al. Gastric emptying of milk in infants and children up to 5 years of age: normative data and influencing factors. Pediatr Radiol 50, 689–697 (2020). https://doi.org/10.1007/s00247-020-04614-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-020-04614-3

Keywords

Search

Navigation