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

ians are putting their patients at a higher risk for infections like pneumonia and gastroenteritis. The use of PPIs in infants can also lead to abnormalities in the levels of essential minerals and vitamins, such as magnesium, calcium, and vitamin B12.

Dr. Hassall encourages his fellow pediatricians to opt initially for nonpharmacological approaches, such as changes in maternal diet of breastfeeding mothers, or hypoallergenic formulas for bottle-feeding infants. However, if these fail, or if an infant has severe symptoms and is suspected of having GERD, Dr. Hassall suggests beginning treatment initially with an histamine-2-receptor antagonist (such as ranitidine or famotidine) for a time-limited period of 2-weeks. If the infant does show improvement, dosage and length of treatment can be increased if necessary, or a trial of once-daily PPI started. However, as Dr. Hassall notes, "In most cases, it is not the spitting up that should be treated. The real issue is the unexplained crying, which causes real and considerable distress and concern for parents." He goes on to explain, "Parents can hardly be blamed for becoming rattled and concerned about their crying infant. It is important to acknowledge their concerns, explain the spectrum of normal infant behavior, discuss the range of measures available, start implementation, and be available for follow-up."


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Contact: Brian Kladko
brian.kladko@ubc.ca
604-827-3301
University of British Columbia
Source:Eurekalert

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