Current Insights into the Pharmacologic and Nonpharmacologic Management of Gastroesophageal Reflux in Infants

Gastroesophageal reflux is common and, in most cases, is a self-limited and physiologic process in infants. However, the role of diagnostic testing and pharmacologic interventions in reflux remains controversial among providers. Various diagnostic modalities exist, but most infants do not require invasive testing and many symptoms traditionally attributed to reflux show no correlation on further testing. There are many strategies for managing reflux in infants. Nonpharmacologic approaches include positioning, thickening, changing formulas, and changing the frequency of feedings, with the benefits of these methods shown to be inconsistent. Many medications now exist to address reflux, particularly by way of acid suppression, but these pharmacologic interventions have risks, especially in young infants, and many of these therapies have shown limited success in truly reducing reflux symptoms. In conclusion, nonpharmacologic approaches should be used, because most symptoms of gastroesophageal reflux will ultimately resolve without any intervention.