A nurse is caring for an infant who has gastroesophageal reflux (GER). Which of the following actions should the nurse take to prevent regurgitation? (Select all that apply.)

Choice A rationale Thickening the infant's formula with cereal increases the viscosity of the feeding, making it more difficult for the infant to regurgitate. This physical property of the thickened liquid helps it to remain in the stomach, reducing the frequency of reflux episodes. This is a common non-pharmacological management strategy for gastroesophageal reflux. Choice B rationale Avoiding citrus juices is a dietary recommendation for older children and adults with gastroesophageal reflux (GER) to prevent esophageal irritation. However, citrus juices are generally not part of an infant's diet, so this action is not relevant to preventing regurgitation in this age group. An infant's diet is primarily milk-based. Choice C rationale Positioning the infant with their head elevated after meals helps to use gravity to keep stomach contents in place and reduce the likelihood of reflux. This position reduces the pressure on the lower esophageal sphincter, making it harder for gastric contents to flow back into the esophagus. This is a key nursing intervention. Choice D rationale Placing an infant's head on a soft pillow while sleeping is a significant safety hazard. The use of soft bedding, including pillows, increases the risk of sudden infant death syndrome (SIDS) by causing suffocation or rebreathing of carbon dioxide. This action should be strictly avoided for infants, as per safe sleep guidelines. Choice E rationale Antiemetics are medications that prevent vomiting and nausea. While they might be used in some cases, they are not the primary or first-line intervention for preventing regurgitation in infants with GER. The first-line approach involves non-pharmacological measures like feeding adjustments and positioning, which are safer and often more effective.