Anti-Reflux Drugs May Be Overprescribed in Infants

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To measure whether or not these infants' symptoms were caused by acid reflux, the researchers conducted pH studies on 44 babies with persistent regurgitation. The average age of the babies was 18 weeks.

To complete a pH study, doctors must thread a wire down the nose and leave it in place for 24 hours, Khoshoo said, so it's not a test that would be practical to do on every child with regurgitation.

Of the 44 babies tested, only eight showed elevated pH levels, meaning they had excess levels of stomach acid, and anti-reflux medications would be indicated in these cases. However, 42 of the babies were already on such medications, meaning that many were taking a medication they didn't need.

While these medications are generally considered safe, Khoshoo said there is some concern that they may affect calcium metabolism, and they've been associated with osteoporosis in older people who take them for long periods of time.Because infants are building new bones, this potential side effect is even more concerning, Khoshoo added.

Dr. David Keljo is a pediatric gastroenterologist and director of the Inflammatory Bowel Disease Center at Children's Hospital of Pittsburgh. He said, "Reflux in babies is a tough issue, and I think the concerns in this study are well-raised. Babies may be cranky from reflux or from something else. The vast majority will outgrow their reflux whether we do anything or not."

Both Khoshoo and Keljo said these medications are probably overprescribed because parents want to do something, anything to try to stop their babies' regurgitation and irritability.

Khoshoo said that taking care not to overfeed your infant and making sure he or she is positioned so that their bodies are at least somewhat upright after eating will help to lessen reflux symptoms. Another critical thing parents can do, he said, is make sure that children aren't exposed to secondhand smoke, which can increase reflux symptoms.

Keljo said there are certain signs that indicate your baby should be evaluated by a specialist. If your child throws up blood, a substance that looks like coffee grounds, or if there's green in the vomit, your child should be seen right away. Also, if your child isn't gaining weight or is even losing weight, if you can hear significant choking sounds, if there's a chronic cough or hoarseness that accompanies regurgitation, your child should see a gastroenterologist, he said.

More information

To learn more about acid reflux in babies, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.