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GERD type symptoms vary widely; may be influenced by volume, height, and composition.Transient LES relaxation is the common mechanism for GER and troublesome symptoms.No single pharmaceutical or non-pharmacological target exists to treat infant GERD.Gastroesophageal reflux disease (GERD) constitutes a troublesome symptom complex resulting from retrograde passage of gastric contents into the esophagus or extra-esophageal regions. Premature-born, high-risk infants and those with neuro-aero-digestive pathologies are at increased risk. Critical review over the last 3 years was conducted, and current opinions on pharmacological targets include agents aimed at prevention of transient lower esophageal sphincter relaxation, modification of the physico-chemical composition of gastric contents, modification of gut motility, or altering sensory thresholds to ameliorate the troublesome symptoms. As data from well-designed studies is limited in the infant population, information from adult studies has been cited where potential application may be helpful.