pediatrics
Gastroesophageal Reflux in Infants
Key Points
Most reflux in infants does not cause other symptoms or complications and resolves spontaneously by age 12 to 18 months. Gastroesophageal reflux disease (GERD) is diagnosed when reflux causes complications such as esophagitis, respiratory symptoms (eg, cough, stridor, wheezing, apnea), iron deficiency anemia, or impaired growth. Clinicians recommend prescribing a therapeutic trial of feeding modifications and after-feeding positioning if GERD symptoms are mild. Consider testing with an upper gastrointestinal contrast x-ray series, gastric emptying scan, esophageal pH probes, or endoscopy for infants with more severe GERD symptoms or for whom a therapeutic trial is not helpful. If the response to therapy is not satisfactory, consider gastroparesis and measure gastric emptying using a gastric emptying scan. Acid suppression with a proton pump inhibitor or H2 blocker may help infants with significant GERD. Most infants with GERD respond to medical therapy, but a few require surgical therapy. 