Gastroesophageal reflux (GER), the regurgitation of gastric contents into the esophagus or mouth, is a common phenomenon among healthy infants, with approximately 50% of 0- to 3-month-old infants and 67% of 4-month-old infants experiencing at least one episode of vomiting per day. GER typically improves through the first postnatal year, with only 5% of healthy 12-month-olds experiencing vomiting. Uncomplicated GER usually can be diagnosed from the history and physical examination, and treatment often is instituted without extensive diagnostic testing.

When symptoms do not respond to treatment as expected, symptoms persist much beyond 1 year of age, GER is suspected to be the cause of epigastric abdominal pain or substernal pain, or extraesophageal symptoms are present (eg, poor weight gain, apparent life-threatening episodes [ALTEs], apnea, pneumonia, treatment-resistant asthma, or chronic cough), GER often is called “complicated GER” or gastroesophageal reflux disease (GERD). GERD has been reported to affect up to 8%...

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