Gastro-oesophageal reflux in infancy

Gastro-oesophageal reflux is very common in infancy. It is important to differentiate benign physiological reflux from gastro-oesophageal reflux disease, which is associated with significant morbidity. This review summarises the approach to infants with symptoms and signs of reflux, differential diagnosis and investigations. We also discuss available treatment options including non-pharmacological, pharmacological and surgical treatments. Most infants with gastro-oesophageal reflux do not require any treatment providing the infant is thriving. Severe cases require a careful diagnostic work up, treatment of associated conditions and aggressive medical management of the reflux. Involvement of the multidisciplinary team is essential and in reflux resistant to standard medical management with significant morbidity surgical intervention needs to be considered.