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Medical management of gastro-esophageal reflux in healthy infants

Isabelle Chevalier1, Carolyn E Beck1, Marie-Joëlle Doré-Bergeron1

  • 1Canadian Paediatric Society, Acute Care Committee, Community Paediatrics Committee, Ottawa, Ontario, Canada.

Paediatrics & Child Health
|December 30, 2022
PubMed

Insights

Gastro-esophageal reflux disease (GERD) in infants often presents with non-specific symptoms. Management should prioritize feeding modifications over medications due to limited evidence and safety concerns.

Area of Science:

  • Pediatrics
  • Gastroenterology

Background:

  • Infant gastro-esophageal reflux disease (GERD) symptoms are often non-specific and mimic normal infant behaviors.
  • GERD is a common condition in healthy term infants under one year of age.

Purpose of the Study:

  • To review evidence for medically recommended management of GERD in infants.
  • To discourage the over-prescription of medications for infant GERD.

Main Methods:

  • Review of current evidence for GERD management in infants.
  • Analysis of risks versus benefits for pharmacological interventions.

Main Results:

  • Feeding modifications (thickening feeds, avoiding cow's milk protein) are recommended.
  • Limited evidence supports pharmacological management; risks often outweigh benefits.
  • Acid suppressive therapy is not routinely recommended, except for suspected erosive esophagitis.

Conclusions:

  • Anticipatory guidance on the natural resolution of reflux symptoms is advised.
  • Non-pharmacological approaches are preferred for managing infant GERD.
  • Judicious use of medications is crucial, avoiding routine prescription.

Keywords:
ChildrenGastroesophageal refluxGastroesophageal reflux diseaseH2 receptor antagonistsInfantsProkineticsProton pump inhibitor

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