Just published in The British Journal of Medicine. This is a quick read with key considerations that inform our practice with infants who present with GERD, and help us speak from a perspective of knowledge.

Mirani, Y., Roy, Y. J., & John, T. (2025). Comparative Analysis of Pharmacological Treatments and Lifestyle Modifications for Managing Gastroesophageal Reflux Disease in Infants: A Literature Review. British Journal of Hospital Medicine, 1-10. Available open source on Google Scholar.

Abstract
Gastroesophageal reflux disease (GERD) is a common condition in infants, causing vomiting, irritability, and feeding difficulties. Though typically mild and self-limiting, severe cases may result in complications such as esophagitis, failure to thrive, or recurrent aspiration pneumonia. This review highlights a tiered approach to management, emphasizing non-pharmacological methods such as feeding adjustments, and thickened feeds as first-line treatments. These strategies are effective for mild to moderate
cases, reducing unnecessary medication risks. Pharmacologic interventions, primarily proton pump inhibitors and histamine-2 receptor antagonists, are reserved for severe cases, such as erosive esophagitis or persistent respiratory symptoms, where non-pharmacological approaches have failed. While medications promote mucosal healing, their efficacy for symptoms like irritability or vomiting in non-severe cases is mixed, raising concerns about overuse. Adverse effects include increased infection risks, gut
microbiota changes, and nutrient malabsorption. Future research should refine diagnostic criteria and develop evidence-based guidelines to prevent overtreatment.