- Symptoms of gastroesophageal reflux disease (GERD) are highly prevalent in children, affecting >25% of infants but disappearing by 12 months, and later affecting up to 38% of children >18 months, according to a systematic review.
Why this matters
- This is the first systematic review of worldwide studies of prevalence and risk factors.
- Systematic review of 25 epidemiological studies (n=487,969), of which 11 were of infants and 14 of children, after a search of PubMed, EMBASE, and Cochrane databases.
- Funding: None.
- Infants (0-18 months):
- GERD symptoms were seen in >25% of infants on a daily basis.
- GERD symptoms recede in frequency and completely disappear by 12 months.
- Children (>18 months):
- GERD symptoms vary widely (range, 0%-38% of children studied).
- Overall, GERD symptoms seen in >10% on a weekly basis and in 25% on a monthly basis.
- Risk factors:
- Gender does not appear to affect prevalence in infants and children.
- Higher BMI and use of alcohol and tobacco are linked to higher GERD prevalence.
- Breastfeeding as a protective factor for reflux is found in some studies, but not others.
- Current guidelines encourage breastfeeding in infants with physiological gastroesophageal reflux but suggest adding thickeners to pumped breast milk if infants have significant reflux.
- Significant heterogeneity across studies.