Gastroesophageal reflux disease in the neonatal intensive care unit

Gastroesophageal reflux (GER), commonly diagnosed in preterm infants in neonatal intensive care units (NICUs), is a cause of morbidity and is known to prolong hospital stay. Pharmacological treatment of presumed or proven GER is increasingly being used in NICUs; this attitude is concerning, owing to an association between pharmacological treatment of GER and serious adverse events, which has recently been demonstrated (i.e., ranitidine and necrotizing enterocolitis). Furthermore, a wide variability exists among NICUs in the proportion of infants treated for GER, which suggests a serious lack of evidence in this field. Thus, there is a need to develop safe and effective treatment options for GER in preterm infants is a critical issue for future research.