Anti-Reflux Drugs May Be Overprescribed in Infants

By Serena Gordon
HealthDay Reporter
Tuesday, November 6, 2007; 12:00 AM

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MONDAY, Nov. 5 (HealthDay News) -- Doctors may be overprescribing anti-reflux medications to infants, new research suggests.

The study found that fewer than one in five babies given anti-reflux medications, which work by lowering levels of stomach acid, actually had elevated acid levels. That means four out of five infants included in the study likely didn't need anti-reflux medications, and may have simply been experiencing normal infant regurgitation commonly referred to as "spitting up."

"In the absence of red flags, such as a child who is not gaining weight, has feeding problems or a learned aversion to food, a chronic cough or recurrent respiratory problems or apnea, regurgitation may not require medication," said study author Dr. Vikram Khoshoo, a pediatric gastroenterologist at the Pediatric Specialty Center at West Jefferson Medical Center in New Orleans.

"Regurgitation won't improve with anti-reflux medications. Acid suppression will improve irritability and feeding problems, but it won't change spitting up. As long as the child is gaining weight and happy, and has no recurrent red flags, regurgitation is a laundry problem, not a medical problem," Khoshoo said.

The findings are published in the November issue of Pediatrics.

Reflux is common in infants. In fact, more than half experience reflux symptoms during the first three months of life, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms of reflux include spitting up, vomiting, coughing, feeding difficulty and irritability.

Khoshoo and his colleagues reported that back in 1998 and 1999, infants with regurgitation made up about 14 percent of their referrals, and about 40 percent of those babies were already on anti-reflux medication or on special easier-to-digest formula. But by 2006 to 2007, infants with regurgitation accounted for 23 percent of their referrals, and 90 percent were already on medications or special formula.

"We felt it was unlikely that the incidence had increased so suddenly," Khoshoo said.