Any words of wisdom on this topic very welcome here!  A slightly lax lower oesophageal sphincter is pretty normal in the under 1s but a lot of energy is expended in trying to do something about the symptoms.  The paper cited in this month’s Paediatric Pearls from the Drugs and Therapeutics bulletin is really rather depressing in its comments on both pharmacological and non-pharmacological management of reflux.  Even surgery doesn’t always work.  It is particularly common among preterm babies and much has been written about that group of patients too – with similar levels of evidence generated as with term infants.  You might want to read: Gastrooesophageal reflux disease in preterm infants: current management and diagnostic dilemmas. J L Birch, S J Newell, Arch Dis Child Fetal Neonatal Ed 2009 or Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the NASPGHAN and the ESPGHAN. J Pediatr Gastroenterol Nutr; 2009 on this topic.