AAP recommendation of a first-line approach to manage reflux

  • “Lifestyle changes are emphasized as first-line [management] in…GER…, whereas medications are explicitly indicated only for patients with GERD. – Lightdale et al. 20131

  • Lifestyle changes


    • Thickening feedings with rice cereal or switching to commercially thickened formula
    • Reducing feeding volume and increasing feeding frequency
    • Keeping infants upright or prone when awake
    • Avoiding semisupine positioning, such as in a car seat, because it may exacerbate reflux
  • Further information from the AAP guidelines1

    “It cannot be overemphasized that pediatric best practice involves…reassuring parents of patients with physiologic GER who are not at risk for complications to avoid unnecessary diagnostic procedures or pharmacologic therapy.” – Lightdale et al. 2013

Differentiating GER from GERD To “D” or not to “D”

Watch as she presents a guideline-based approach for understanding the difference between GER and GERD, reassuring parents that GER is not harmful in most cases, and identifying which patients will benefit from treatment for GERD.

Program Presenter:

Jenifer R. Lightdale MD, MPH
Gastroenterology and Nutrition University of Massachusetts Memorial Medical Center
Worcester, MA

(Formerly of Boston Children’s Hospital, Harvard Medical School)


  • Reference: 1. Lightdale JR et al. Pediatrics. 2013; 131:e1684-e1695.