Some experts feel that acid reflux is over-diagnosed in babies

October 23rd, 2011 by | Permalink

Medication over-prescribed for babies who spit up, according to experts. Via Google Images

Some experts believe that the growing trend of using medications to suppress stomach acid in infants not scientifically sound or beneficial to babies.

Dr. Eric Hassall, a pediatric gastroenterologist from Sutter Pacific Medical Foundation in San Francisco, blames advertising for acid reflux medications, lack of undertanding of infants’ normal responses and a cultural tendency to over-medicate.

One study of about 1 million infants showed that prescriptions for proton-pump inhibitors (PPIs) for infants were 7 times more common in 2004 than in 1999, Hassall said. PPIs (like Prilosec, Prevacid and Nexium) block the production of acid in the stomach.

That study showed that prescriptions for one child-friendly liquid PPI rose 16-fold throughout the study period. The study also showed that PPIs were prescribed to about 0.5 percent of babies under 1 year old, with about half of those prescriptions being given to infants four months of age.

Hassall wrote that crying and spitting up have “long been observed in otherwise healthy, thriving infants.” He also wrote that as many as 40 to 70 percent of infants spit up on a daily basis, and this reflux is normal, not gastrointestinal reflux disease (GERD), but parents are regularly exposed to advertising that may cause them to “blur the lines between normality and pathologies.”

The Journal of Pediatrics contains Hassall’s complete commentary.

Spitting up is due to an infant taking in more food than they can hold; it is normal and resolves on its own at least 95 percent of the time, Hassall wrote. Yet  spitting up and crying are increasingly “conflated into a diagnosis of GERD.”
The largest clinical trial of PPI’sin infants found no difference between a proton pump inhibitor and a placebo. There is actually danger in reducing normal acid secretion in infants. Hassall wrote, “Gastric Acid is an early line of defense against infection and important for absorption of certain nutrients.” He elaborated that infants might be at risk for certain illnesses just because they took a proton-pump inhibitor.
Hassall believes that a key to reducing the overuse of acid-suppressing medications would be stopping the routine use of words like GERD and acid reflux in referring to infants.  He wrote “These symptoms and signs are just “life,” not a disease, and as such do not warrant drug therapy.”

Dr. Beth Tarini, a pediatrician at the University of Michigan, said, “I am just as guilty as the mothers, who come in distraught by crying and spitting up…This is something that has been medicalized, and we need to tell parents that this is just an unfortunate bump in the road.”

Read more: http://www.foxnews.com/health/2011/10/20/acid-reflux-treatment-for-babies-draws-criticism/#ixzz1bNPqgPV9

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