Navigation Links
Are acid-suppressing drugs prescribed too often in infants?

Cincinnati, OH, October 20, 2011 Frequent spitting up, irritability, and unexplained crying in infants can be very distressing to parents. Pediatricians often prescribe acid-suppressing drugs for these symptoms in an effort to treat infants for gastroesophageal reflux disease (GERD); however, GERD is an uncommon cause of these symptoms in otherwise thriving infants. In a soon to be published Commentary in The Journal of Pediatrics, Eric Hassall, MBChB, FRCPC, FACG, cautions against the over-diagnosis of GERD and over-prescription of acid-suppressing drugs in infants.

Dr. Hassall is affiliated with the Department of Pediatrics at the University of British Columbia, Vancouver, Canada, is currently Staff Gastroenterologist at Sutter Pacific Medical Foundation in San Francisco, California, and is an advisor to the U.S. Food and Drug Administration (FDA). Although the FDA has only approved the use of acid-suppressing drugs, such as proton pump inhibitors (PPIs), in children over the age of one year, the use of PPIs in infants less than 12 months old has greatly increased in the last decade.

Dr. Hassall notes that most "reflux" in infants is not acidic because stomach contents have been buffered by frequent feedings. "However, in the absence of better information and physician guidance and fed by advertising and misinformation on the Internet, distressed parents take their concerns to doctors, who very frequently comply and prescribe acid-suppressing medications for symptoms and signs that, in most cases, are not GERD," he states.

Studies have shown that PPIs are no better than placebo for most infants with symptoms of spitting up, irritability, or unexplained crying, which may be because the medications are frequently prescribed for symptoms that are not GERD. Dr. Hassall emphasizes that spitting up in otherwise healthy infants is normal and resolves with time. Irritability or unexplained crying, with or without spitting up, is often a normal developmental phenomenon, especially in infants 2-5 months old. Although some infants are unable to self-calm, this also improves with maturation and age.

"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 is important for nutrition; by prescribing acid-suppressing medications to infants without GERD, pediatricians 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 initially explore nonpharmacological approaches, such as changes in maternal diet of breastfeeding mothers or hypoallergenic formulas for bottle-fed infants. However, if these approaches fail or if an infant has severe symptoms and is suspected of having actual GERD, Dr. Hassall suggests beginning treatment with an acid-suppressing medication for a time-limited period of 2 weeks. 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 say, "It is important for pediatricians 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."


Contact: Brigid Huey
Elsevier Health Sciences

Related medicine news :

1. Hypertension, Not Blood Pressure Drugs, Linked to Birth Defects
2. Antiviral drugs may slow Alzheimers progression
3. Tests to catch the makers of dangerous legal high designer drugs
4. $8.4 million grant supports health information exchange and research on Alzheimers drugs
5. Mushroom compound appears to improve effectiveness of cancer drugs
6. Study uncovers why anti-rejection drugs for transplant patients cause hypertension
7. Many Years Pass Before Folks Get Help for Drugs, Alcohol
8. Marijuana component could ease pain from chemotherapy drugs
9. The witch doctors gift: Potential new drugs from a cup of tea
10. Popular Diabetes Drugs May Raise Pancreatic Cancer Risk, Study Suggests
11. Blood pressure drugs may lengthen lives of melanoma patients
Post Your Comments:
(Date:11/30/2015)... (PRWEB) , ... November 30, ... ... two new additions to its industry-leading suite of automated breast density assessment ... North America (RSNA) meeting, November 29-December 4, 2015 (South Hall booth #2377). ...
(Date:11/30/2015)... ... 2015 , ... Holcomb – Kreithen Plastic Surgery and ... in Florida, is proud to announce that Dr. Joshua Kreithen, one of its ... a Johnson & Johnson Company. , Ethicon is a global medical device company ...
(Date:11/30/2015)... ... ... The successful filing of an Investigational New Drug application (IND) is a ... key industry segment, Regis Technologies has decided to sponsor and participate in an XTalks-hosted ... , Federal law does not allow new drugs to cross state lines until it ...
(Date:11/30/2015)... (PRWEB) , ... November 30, 2015 , ... ... the assets of DataTrade Solutions Inc., a Healthcare IT consulting, development and support ... the programming and technical experience available within DataTrade to extend the services currently ...
(Date:11/30/2015)... ... 2015 , ... GKhair & Tibolli team members and artists were excited and ... November 8th and 9th at the Puerto Rico Convention Center, San Juan Puerto Rico. ... top of the line fashion journalists. The San Juan Beauty Show carries immense credibility ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... 2015 --> --> ... Market by Product (Soft Tissue, All Tissue, Dental Welding Lasers), ... and Geography - Global Forecast to 2020", published by MarketsandMarkets, ... a CAGR of 5.2% during the forecast period from 2015 ... and 62 Figures spread through 167 P ages and ...
(Date:11/30/2015)... ST. LOUIS , Nov. 30, 2015  Premera ... today announced an early renewal of the companies, long-standing ... will now extend through at least 2019. ... pharmacy benefit manager capabilities during a competitive review and ... offer the best health plan integration and deliver the ...
(Date:11/30/2015)... 2015 Booth #4303 – The Imaging Components business ... a broader array of products in a new booth (#4303) ... North America in Chicago ... feature X-ray components "At the Heart of Imaging." Products will ... from Varian,s Claymount brand, and computer-aided diagnostic software from MeVis ...
Breaking Medicine Technology: