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Overprescription of Acid Reflux meds (&cow milk protein problems for bf babies)

Posted by on Nov. 22, 2011 at 12:26 PM
  • 37 Replies
1 mom liked this

http://abcnews.go.com/Health/babies-receive-acid-reflux-meds-doc/story?id=14926271#.TsvA8bLNnhU

 

 this article was posted on Best for Babes fb wall, from an ABC news story:

Too Many Babies Receive Acid Reflux Meds, Says Pediatrician

PHOTO: A doctor's study finds that many parents now give their babies acid reflux medication to stop them from spitting up.
A doctor's study finds that many parents now give their babies acid reflux medication to stop them from spitting up. (Getty Images/Radius Images)
  
By (@mikaelaconley)
Nov. 11, 2011

 

Babies will be babies, said Dr. Eric Hassall, staff pediatric gastroenterologist at Sutter Pacific Medical Foundation in San Francisco.

They cry and spit up. Hassall strongly reiterates that point in a commentary he published in the Journal of Pediatrics in which he expresses worry over the drastic rise in the number of parents giving acid reflux medication to their infants in an attempt to keep them from spitting up.

Hassall found that the use of proton pump inhibitors, a group of drugs meant to reduce gastric acid production, grew exponentially for babies less than a year old over the past decade.

He blames advertising and pharmaceutical company promotion for the increase, as well as misleading misdiagnoses. One study that analyzed data of more than 1 million babies found a sevenfold increase in the amount of acid reflux medication prescribed to infants between 1999 and 2004. About .5 percent of the infants studied in the research received the medication within the first year of their lives, and half of those babies received the drugs before they were 4 months old.

While it is difficult for parents to watch their child scream and spit up from perceived pain, Hassall emphasized that spitting up and crying in an otherwise healthy baby is normal. Despite this, babies are increasingly getting misdiagnosed with gastroesophageal reflux disease, or GERD, a condition in which food and liquid in the stomach leak backward into the esophagus.

The FDA has not approved these drugs for children under a year old because no studies have found them effective in that population.

"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," Hassall said in a statement. "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."

In certain circumstances, there may be an indication that medication is needed, said Keith Ayoob, associate professor of pediatrics at Albert Einstein College of Medicine.

"But when you see a sevenfold increase in PPI prescriptions, you worry that the condition is being overdiagnosed, or if reflux is sort of a garbage-can diagnosis used anytime a child is crying and there's no obvious cause," said Ayoob. "You also get concerned that, if the medication does seem to produce relief, that reflux is truly the cause, or if it's perhaps hiding something else."

Gastric acid is an early line of defense against bacteria, said Hassall. By prescribing acid reflux medication, the babies are at higher risk for pneumonia and gastroenteritis.

Before turning to medication, Hassall encouraged parents to try a few nonmedications first. Oftentimes, severe unexplained crying in healthy kids is caused by a sensitivity to a cow's milk protein. When severe unexplained crying occurs in otherwise healthy infants, prevalent causes include sensitivity to a cow's milk protein.

Mothers who are breastfeeding should try tweaking their diets, like taking out caffeine, chocolate and garlic, which are known to promote acid reflux. Try smaller, more frequent feedings and hold the baby upright during feedings. To calm crying babies, rhythmically rock them or take them on a car ride, experts said.

"I think there are very limited reasons, if any, to use these drugs," said Dr. Ian Holzman, chief of newborn medicine at Mount Sinai School of Medicine. "The risk is that eliminating gastric acid leads to a change in the normal bacteria in your GI track, which could have implications for infection, immunity and digestion. Most, maybe all, babies spit up and no treatment is required. I know of no good evidence that this practice has a value."

"Parents can hardly be blamed for becoming rattled and concerned about their crying infant," said Hassall. "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."

by on Nov. 22, 2011 at 12:26 PM
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Replies (1-10):
mjp2707
by on Nov. 22, 2011 at 12:31 PM
Awesome
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mitty18
by Bronze Member on Nov. 22, 2011 at 1:54 PM
If a pediatrician gives medication for an illness without proof that the child has that particular illness, then there is a bigger problem then just over diagnosing.
Acid reflux isn't just spitting up, and crying. It's undeniable pain in the baby accompanied by frequent spitting up and crying. If a parent suspects that their baby has GERD, then the doctor should do some testing before making that diagnosis. A 24 hr. PH probe or an upper GI series are two tests to diagnose GERD. After a confirmed diagnosis, then the parent and doctor should discuss treatment options. Medication should always be a last resort.
And anyways, acid reflux medication relieves the discomfort in the patient, it doesn't always stop the spitting up.
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mostlymaydays
by Group Mod-Stacy on Nov. 22, 2011 at 2:41 PM
I can't tell you how many babies I keep hearing are on acid reflux drugs, because of fussiness and spitting up, no diagnostic testing. Every day here, another one.
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jrabbit70
by on Nov. 22, 2011 at 2:54 PM

This was very helpful...I'm actually going in to the dr today worried about my 11 week old waking every 30-45 min at night in complete pain due to burps and spit up and was wondering whether to just start the meds if the dr recommended it or ask for diagnostic tests first...I don't want to put her through too many tests...but it sounds like a better option then just starting meds! 

RutterMama
by on Nov. 22, 2011 at 3:07 PM

Very interesting!

mostlymaydays
by Group Mod-Stacy on Nov. 22, 2011 at 3:14 PM
And I had no idea the FDA hadn't approved these drugs for babies under 1!
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Char07
by on Nov. 22, 2011 at 4:09 PM

This... had no idea about that as well.  My 3 yo was put on them at 2 months old, I was told it COULD NOT be a problem with my diet and to not bother changing it, turns out she has a severe dairy protein problem (that all the while consuming it until age 2) caused her to become severely anemic + more.  I will always recommend that *if* and only if it is a problem and hurting baby then mom look into OAL (if nursing), then dairy, then other foods, then lastly to a dr to look into GERD (and not just a "oh your baby spits up here's some zantac, prevacid, etc...").  It happened to mine and I have been at appts with 2 other family members where the dr casually asked if the baby spits up, mom said yes and dr handed over a Rx for antacids!!!  Absolutely ridiculous :(

Quoting mostlymaydays:

And I had no idea the FDA hadn't approved these drugs for babies under 1!


mostlymaydays
by Group Mod-Stacy on Nov. 22, 2011 at 4:54 PM
It's really scary that they're giving babies drugs that change the way their bodies work! Not just like Tums which work by a chemical reaction, neutralizing acid. These reflux meds slow down or shut down the body's acid for digestion. Believe me I don't doubt that some babies need these meds for chronic acid reflux but it's horrifying that they're prescribed at seven times the rate as several years ago, almost always without a single test.
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collinsmommy0
by Gold Member on Nov. 22, 2011 at 6:37 PM
Me too.

My pedi was *sure* that eliminating dairy wouldn't make a difference. DS gained almost 5 pounds in 2 months, spit ups & excema are now minimal, & neon green poops are gone.

But if more people recognized it, then formula companies would have to change their formulas to be dairy free (& we all know that's not going to happen without people paying $$$$$ like they do for neocare).

My cousins baby, who is ff, has excema, green poops, & lots of spit up. Her dr recommended a 'dairy sensitive' formula & more solids. She still isnt convinced her DS has a dairy issue.


Quoting mostlymaydays:

I can't tell you how many babies I keep hearing are on acid reflux drugs, because of fussiness and spitting up, no diagnostic testing. Every day here, another one.

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angelbabies14
by on Nov. 22, 2011 at 6:48 PM
1 mom liked this

This is EXACTLY what I've been trying to tell people for a long time.  I get questioned all the time "what's wrong with using a PPI?"  Everyone is also probably tired of hearing me suggest that food sensitivities, intolerance and allergies are responsible for most Reflux and GERD problems.  Those things are just symptoms!  They are symptoms of an underlying issue.  I need the link to this article so i can start using it to back up what I'm saying.  I've tried to help so many mothers of kids with "reflux" and they swear its not food related.  PPI should a LAST resort. Not the first thing prescribed.  THIS is why I don't like Dr's.

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