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Key messages

Gastro-oesophageal reflux is common in infants. But it is often misdiagnosed and treated unnecessarily with acid suppression therapy (AST).

AST has been shown to have no benefit for infants with gastro-oesophageal reflux or unsettled behaviours. In fact, the latest evidence shows ASTs are associated with an increased risk of gastroenteritis, community-acquired pneumonia, Clostridium Difficile infection, fractures and micronutrient deficiencies and asthma in infants.

Please use our clinical and parent resources to reduce unnecessary prescribing.

Developed with the Royal Children's Hospital, our resources will help you:

  • diagnose gastro-oesophageal reflux (versus gastro-oesophageal reflux disease)
  • understand potential harms and benefits of AST
  • recommendations ceasing AST
  • manage irritability, excessive crying and unsettled behaviours in infants.

Download resources

Resources include guidance for clinicians and information you can give to parents to help them make informed decisions about their child’s care.

Watch our webinar

Infant gastro-oesophageal reflux and irritability: How to diagnose and manage

This webinar covers:

  • how to diagnose and manage infants with gastro-oesophageal reflux and gastro-oesophageal reflux disease
  • the harms and benefits of acid suppression therapy 
  • normal infant crying patterns
  • strategies to help settle infants to sleep.

The webinar is part of a study on the management of infant reflux or irritability or excessive crying or colic, by the Royal Children’s Hospital in partnership with Angliss Hospital, Box Hill Hospital, Frankston Hospital and Goulburn Valley Health.

Guidance for managing infants with gastro-oesophageal reflux and unsettled behaviours

The Paediatric Improvement Collaborative has endorsed clinical practice guidelines:


We developed these resources with the Royal Children's Hospital and trialled them in three Victorian hospitals.

The trial resulted in:

  • 21 per cent reduction in AST prescribing in infants
  • 46 per cent increase in clinicians advising parents to cease ASTs in infants
  • 19 per cent increase in parents recognising that ASTs can cause harm in infants.

Read more, including our projects summary report. 

Get in touch

Centre of Clinical Excellence - Women and Children
Safer Care Victoria

Page last updated: 19 Feb 2021

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