Too Many Babies Take Anti-Reflux Drugs
Study Shows Some Infants Get Treated for GERD Unnecessarily
Babies and GERD Medication continued...
"If you remove these exposures, at least 25% of babies will get better within a few weeks," he says. "They may continue to spit up, but they will be much happier."
He adds that the long-term safety of treating infants with powerful acid-suppressing drugs remains unknown.
While studies have shown the drugs to be generally safe in older children with reflux disease, there is also a suggestion that their long-term use may increase vulnerability to pneumonia and gastric disease.
Reflux Red Flags
Khoshoo says babies who spit up frequently should be evaluated for reflux disease if they are not gaining weight normally, if they have recurrent respiratory symptoms or wheezing, and if they are constantly irritable.
Forceful vomiting is another red flag that should not be ignored.
"If a baby is gaining weight and generally happy, the chances are very good that they have uncomplicated reflux that does not need drug treatment," he says.
When the babies in Khoshoo's study who did not have clinically relevant reflux were taken off anti-reflux drugs, most did not experience an increase in symptoms.
There are things parents can do to minimize normal spitting up. The Children's Digestive Health and Nutrition Foundation has these recommendations:
- Avoid overfeeding. Don't feed the baby again immediately after he spits up. Instead, wait until the next scheduled feeding.
- If a baby is formula fed, thickening the formula with rice cereal may help. But Khoshoo cautions that doing this without reducing formula volume will result in overfeeding, which could make the problem worse. He says a baby normally given 6 ounces of formula during a feeding should be fed 4 ounces of formula thickened with 4 tablespoons of cereal.
- Avoid exposure to cigarette smoke.
- Keep an infant upright for at least 30 minutes after feeding.
Khoshoo also recommends putting babies to sleep on their backs at a 30 to 45 degree angle "to let gravity work for you."