Which treatment is suggested for infants diagnosed with gastroesophageal reflux disease that have persistent symptoms?

For infants diagnosed with gastroesophageal reflux disease (GERD) who exhibit persistent symptoms, the suggested treatment involves the use of H2 blockers or proton pump inhibitors (PPIs). These medications are effective in reducing gastric acidity, thereby minimizing symptoms such as regurgitation and discomfort associated with reflux.

H2 blockers, such as ranitidine or famotidine, and PPIs, such as omeprazole or lansoprazole, act by inhibiting stomach acid production, which can help improve symptoms and promote healing of the esophagus when inflammation is present. The use of these medications is considered especially important when lifestyle modifications and thickened feedings do not sufficiently resolve the symptoms.

In contrast, while increasing fluid intake and monitoring are often initial strategies for managing mild cases of reflux, they may not adequately address the persistent symptoms seen in a more severe presentation of GERD. Antibiotics are not indicated for GERD unless there is a specific diagnosis of an underlying infection, which is uncommon in these cases. Therefore, pharmacologic intervention with H2 blockers or PPIs stands out as the appropriate treatment for persistent symptoms related to GERD in infants.