Managing gastro-oesophageal reflux in infants.

Transient, inappropriate relaxation of the lower oesophageal sphincter may permit contents of the stomach to pass into the oesophagus (so-called gastro-oesophageal reflux [GOR]). This usually presents as regurgitation or vomiting and is common in infants, when it is usually mild and self-limiting, and requires no specific treatment. Gastro-oesophageal reflux disease (GORD) in infants describes reflux of gastric contents that causes troublesome symptoms or complications. GORD is sometimes wrongly diagnosed in healthy infants with troublesome but harmless symptoms of 'physiological' GOR. This has led to increasing, potentially inappropriate, use of acid reducing drugs. Furthermore, few of the drugs used to treat infants with GORD are licensed for this indication, a situation that DTB criticised 12 years ago. Here we consider GORD in infancy (i.e. in those aged 0-12 months), the treatments available and when these are needed.