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Acid-suppressing medications may be overprescribed for infants
Date:10/20/2011

because the medications are frequently prescribed for symptoms that are not GERD. He emphasizes that spitting up in otherwise healthy, thriving infants is normal, and resolves with time; this is known as "physiological reflux." As infants have a limited range of responses to stimuli, it can be difficult to diagnose their cause. Irritability or unexplained crying, with or without spitting up, is often a normal developmental phenomenon especially in infants two to five months or so, less commonly thereafter. Some infants, once crying, are unable to self-calm. This improves with maturation and age. "The state of being new in the world and getting used to new bodily sensations, such as gassiness," also may contribute. When severe unexplained crying occurs in otherwise healthy infants, prevalent causes include sensitivity to cow's milk protein or other dietary components, including those that are present in breast milk. Nonpharmacological measures such as dietary changes, together with 'tincture of time' and reassurance, usually result in resolution.

As Dr. Hassall explains: "In the absence of better information and physician guidance and fed by advertising and misinformation on the Internet, parent blogs have increasingly promoted the ''my-baby-has-acid-reflux-and-needs-drugs'' concept. Parents, concerned by their infant's symptoms of apparent suffering, take their concern to doctors, who very frequently comply and prescribe acid-suppressing medications for symptoms and signs that in most cases are not GERD. GERD-mania is in full cry, so to speak."

"We are medicalizing normality," Dr. Hassall asserts, "In most infants, these symptoms are 'life,' not a disease, and do not warrant treatment with drugs, which can have significant adverse effects." He explains that gastric acid is an early line of defense against infection, and important for nutrition, and by prescribing acid suppressing medications, especially PPIs, to infants without GERD, pediatric
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Contact: Brian Kladko
brian.kladko@ubc.ca
604-827-3301
University of British Columbia
Source:Eurekalert

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