Gastroesophageal reflux disease (GERD) is being misdiagnosed in infants, and doctors are giving them medications that put them at risk for a host of unwanted side effects, one pediatrician argues.
Dr. Eric Hassall, a pediatric gastroenterologist from Sutter Pacific Medical Foundation in San Francisco, writes in a new commentary that spitting up and crying are normal behaviors in healthy infants, but cultural "medicalization" and advertising for acid reflux drugs have caused parents and doctors to "blur the lines between normality and pathologies."
Hassall cites one study that shoed a 7-fold rise in prescriptions for proton-pump inhibitors (PPIs), which block the production of stomach acid, for infants between 1999 and 2004, even though there is no science backing their use in infants.
Hassall says prescription of PPIs for healthy infants who don't have GERD can lead to the reduction of normal stomach acid secretion, pneumonia, gastroenteritis, food allergies and nutritional deficiences.
Spitting up occurs in 40 to 70 percent of infants and resolves on its own in more than 95 percent of infants. But too often, it is "conflated into a diagnosis of GERD." In addition, increased crying in the first three to five months is normal and in rare cases, an issue such as a milk allergy may be the cause.
But everyone needs to understand that "These symptoms and signs are just "life," not a disease, and as such do not warrant drug therapy," Hassall wrote.
The commentary appears Oct. 20 in the Journal of Pediatrics.
