Objective: To investigate the current approach of Australia and New Zealand paediatricians to children with gastrooesophageal reflux symptoms, comparing practice against the NASPGHAN-ESPGHAN guideline. 

Method: Prospective, multicentre study was carried out in Australia and New Zealand between November 2012 and June 2013. Questionnaires were distributed, consisting of multiple choice case reports like issues, concerning clinical management, the use of diagnostic tools and the treatment options for Gastro-Oesophageal Reflux Disease (GORD) in infants, children and adolescents, via email to a selected email list of paediatricians across the country.  

Results: 53 paediatricians completed the study questionnaire. 71.7% diagnosed GORD based on symptomatology, irrespective of the child’s age. 45.2% prescribed Proton Pump Inhibitors (PPIs) to children of all ages, whilst 39.6% prescribed mainly to infants. In infants, 39.6% of these prescriptions were for uncomplicated recurrent regurgitation and vomiting and 66% were for unsettled behaviour, without specific testing. 50% of prescribed PPIs in children older  than 5 years of age were for vomiting and heartburn, without investigating. 30.7% would discontinue PPIs abruptly and only 50.9% were aware that the most frequent adverse event of PPI therapy in infants is lower respiratory tract infection. 26.4% of paediatricians wrote > 15 PPI prescriptions during the last 6 months. 

Conclusion: The results of this survey showed varied response on the management of GORD in Australasia. Paediatricians in Australasia were overprescribing PPIs in infancy for resumed symptoms of GORD in the absence of diagnostic evidence.