Objective: To investigate the current approach of Australia 
and New Zealand paediatricians to children with gastro
oesophageal 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 presumed symptoms of GORD in the absence 
of diagnostic evidence.