Uncomplicated reflux (GER) vs GERD

  • Reflux in healthy infants is often misunderstood by parents1


  • More than 2/3 of otherwise healthy infants may experience uncomplicated reflux (GER)

    Parents may be using reflux (spit-up), and irritability (crying) to identify GERD or acid reflux in their otherwise healthy babies. Since medication is used to treat GERD in adults, parents may think their baby needs medication to address these issues.1


  • The difference between reflux in healthy infants and true GERD2


    The difference between reflux in healthy infants and true GERD



  • Gastroesophageal Reflux occurs in more than 2/3rd of otherwise healthy infants and is the topic of discussion of pediatricians in ¼ of all routine 6 month infant visits. In this video, Dr Gold will review best practices for Gastroesophageal Reflux, specifically AAP clinical report regarding GER / GERD and NASPGHAN/ESPGHAN recommendations for infants with recurrent regurgitation and vomiting.


    **Benjamin D. Gold, MD, FACG**
    Pediatric Gastroenterology,
    Hepatology, and Nutrition
    GI Care for Kids, LLC
    Children’s Center for Digestive healthcare, LLC
    Atlanta, Georgia

    The studies described in this presentation were not conducted with Mead Johnson formulas, nor are they presented to suggest Mead Johnson formulas diagnose, cure, mitigate, treat, or
    prevent disease. Unauthorized reproduction of any parts of this presentation is prohibited.


  • An important conversation to have with parents about medication in healthy infants


    • Uncomplicated reflux (GER) is not caused by excess acid, so suppressing acid production may not help3
    • Acid reflux medications (H2RAs, PPIs) work by suppressing the production of gastric acid
    • Studies suggest that acid suppression medications are no more effective than placebo in this population3

    Potential disadvantages of acid reflux medications


    • Gastric acid is an early line of defense against infection and important for the digestion and absorption of nutrients4
    • Emerging evidence suggests that acid suppression using H2RAs or PPIs is associated with an increased prevalence of acute gastroenteritis and community-acquired pneumonia in children 4-36 months5, as well as increased risk of C. difficile infection in infants and children (0 - 17 years of age)6
    • PPIs are not FDA approved for use in infants

    References: 1. Scherer LD et al. Pediatrics. 2013; 131:839-845. 2. Lightdale JR et al. Pediatrics. 2013; 131:e1684-e1695. 3. Vanderplas Y et al. J Pediatr Gastroenterol Nutr. 2009; 49:498-547. 4. Hassall E. J Pediatr. 2012; 160:193-198. 5. Canani RB et al. Pediatrics. 2006; 117:e817-e820. 6. Freedberg D et al. Clin Infect Dis. 2015; 10.1093/cid/civ432