Snapshot An 8-month-old girl is brought to the pediatrician by her parents for a well-baby visit. The parents report that their only concern is that the patient "spits up" her food. The parents say that she is exclusively breastfed and denies any increased irritability, abnormal behavior, diarrhea, or vomiting. Physical examination is unremarkable. Parent education and recommendations are implemented. Introduction Clinical definition gastric contents going into the esophagus in the absence of pathologic consequences login to view 2 more bullets Epidemiology Incidence very common in infants and login to view 1 more bullet ETIOLOGY Pathogenesis transient lower esophageal sphincter relaxation Presentation Symptoms "spitting" up login to view 1 more bullet Physical exam typically a normal physical exam Differential GERD symptoms login to view 4 more bullets complications login to view 4 more bullets DIAGNOSIS Diagnostic criteria this is a clinical diagnosis Treatment Conservative increasing caloric density while decreasing feed volume login to view 2 more bullets thickening feeds login to view 2 more bullets Complications By definition GER is considered in the setting of reflux without pathological consequences Prognosis Uncomplicated GER has a favorable prognosis because the infant will "outgrow" the frequency of regurgitation