Many infants have periods of unsettledness, or irritability, over the first months of life. Spilling (or posseting) due to reflux of gastric contents is also seen very frequently. Almost universally, these are normal patterns of infancy (the first 12 months of life) that resolve with the passage of time. In recent years, these normal developmental processes have increasingly been ascribed to pathology and treated with medical therapies, including acid suppressants. There is clear evidence, however, that acid suppression has no role in the management of these behaviours. In addition, recent data illustrate increased risk of adverse effects of these drugs in infants.