A nurse is reinforcing teaching with the parents of a 2-month-old infant who has gastroesophageal reflux. The parents are feeding the infant formula. Which of the following instructions should the nurse include in the teaching?

Gastroesophageal reflux (GER) in infants occurs because the lower esophageal sphincter is immature, allowing stomach contents to regurgitate upward. Keeping the infant at a 30-degree upright angle for at least 30 to 60 minutes following each feeding uses gravity to help keep formula in the stomach and reduces regurgitation. This is a standard, evidence-based positional intervention recommended for formula-fed infants with GER. Giving a bottle immediately before bedtime is inadvisable because placing the infant supine right after feeding worsens reflux by removing gravitational assistance. Limiting feedings to every 6 hours is inappropriate and potentially unsafe for a 2-month-old, who typically requires feedings every 2 to 3 hours; additionally, larger, less frequent feedings increase gastric distension and worsen reflux. Changing to a soy-based formula is not a first-line recommendation for GER unless there is a confirmed cow's milk protein allergy or intolerance; standard management focuses on thickening feedings and positional strategies before formula changes. Students should understand that the upright positioning approach is consistently recommended in clinical guidelines as an initial non-pharmacological management strategy for infantile reflux, making it the most appropriate teaching point in this scenario.