Are proton-pump inhibitors (PPIs) an appropriate therapy for infantile reflux?—WALTER BUSSEY, PA-C, MPAS, Council Bluffs, Iowa

If acid suppression is going to be tried in an infant with reflux, a PPI is the preferred choice; however, the role of acid in gastroesophageal reflux—especially in children without endoscopic proof of esophagitis —remains up for debate. Before prescribing medication, make sure you have tried formula thickening, a milk-free diet, and positioning changes first, and remind parents that even frequent spitting in a child who is happy and gaining weight—and has no apnea, cough, or wheeze—is not a disease.—Reuben W. Zimmerman, PA-C (140-3)

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