ABSTRACT
Gastro-oesophageal (GO) reflux is considered physiological when the infant thrives with some posseting/vomiting. When GO reflux is causing complications, example irritability, disrupted sleep, choking, aspiration pneumonia and/or poor weight gain, it is termed GO reflux disease. Early increase in crying in a healthy infant is the most common stimulus for shaken baby syndrome. This is a potentially lethal form of physical abuse causing brain injury, for example subdural haematoma, with 80% significant brain injury and 20% death. Early detection of psychosocial problems is very important because it can result not only in poor physical growth but also in poor cognitive and intellectual development. Physical examination should focus on sites most likely to be the cause of fever, including the operative site, abdomen and upper respiratory tract for infection and lung auscultation. Repeated physical examinations are more helpful in establishing a diagnosis than extensive investigations.
