Managing gastro-oesophageal reflux in infants and children.

Dr Beattie describes the different types of gastrooesophageal reflux and the investigations that may be needed. Management in infants and children is discussed, from simple measures through to more complex medications and, in a minority of cases, surgery. Mild reflux occurs in 50% of all babies and most cases are managed by health visitors and general practitioners. Simple strategies, including feeding advice and reassurance about the natural history, are usually sufficient. Feed thickeners or an anti-reflux milk help in selected cases. There is a need, however, for careful clinical assessment of cases and consideration of the differential diagnosis. It is important that resistant or difficult cases are assessed by a paediatrician with an interest in reflux.