The role of overfeeding in infants with brief resolved unexplained events (BRUE): a prospective observational study

Abstract Background Although inappropriate feeding has been suggested to play a role in the occurrence of BRUE, only anecdotal reports have been so far described. The main objective of our study was to objectively evaluate whether overfeeding may represent a risk factor for the occurrence of BRUE. Methods We enrolled 42 infants aged 0–6 months admitted for BRUE episodes and a same number of age- and sex-matched healthy infants, who served as controls. Data about feeding practices and auxological parameters of each enrolled infant were collected and analysed, along with clinical data about peri- and post-natal period. Main outcome measures were mean daily body weight gain, daily number of feedings and mean volume of feedings and average daily volume of feedings only for bottle-fed infants. Results The mean (± SD) daily body weight gain, the only available and reliable parameter to assess feeding adequacy in both breast- and formula fed infants, was 41 ± 15 grams in infants with BRUE vs 35 ± 11 grams in healthy infants (95% CI [0.21; 11.8], p = 0.042). Moreover, infants with BRUE were more likely than controls having received mixed breastfeeding, although this difference did not reach statistical significance (33% vs 17%, 95 CI [-0.04; 0.37], p = 0.131). Conclusions Overfeeding seems to be a risk factor for the occurrence of BRUE, either through milk inhalation and choking or through GER worsening. Detecting inappropriate feeding practices, and providing appropriate education to correct them, may help preventing the occurrence of BRUE produced by either scenarios.