Overdiagnosis of Reflux in Infants

Diagnosis of reflux in colicky infants is on the rise. Unfortunately, this means that doctor’s recommendation of acid-suppressing medication in infants is also on the rise. Is it that infants have more reflux than they did in the past, or are doctors overdiagnosing reflux (just as they do in adults)? According to a recent study published in the journal Pediatrics, researchers found that physicians tend to easily label common symptoms in infants, such as crying and spitting up, as reflux disease. 

“As doctors, we need to appreciate that the words we use when talking with patients and parents have power—the power to make a normal process seem like a disease. As pediatricians, our job is to make sick children healthy, not healthy children sick,” stated Beth Tarini, MD, one of the researchers. Laura Scherer, PhD, another researcher, continued, “The growing digestive systems of an infant can be finicky and cause the child to regurgitate. The discomfort can cause the infant to cry, but it is not necessarily a disease.”

The long-term side effects of acid-suppressing medication in infants have not been adequately investigated, with some studies linking its use to increased risk of pneumonia. Quite frankly, safety and effectiveness of most of these medications in infants have not been established. Fortunately, there are other, safer approaches that can be taken when it comes to colic induced by reflux. I have blogged about one potential solution previously—probiotics.

The first step when it comes to infant reflux is to observe the baby’s eating habits. Decreasing feeding amount while increasing frequency may help to keep baby’s stomach less full at any one time. Holding baby upright after feeding will help keep stomach contents down and reduce reflux. 

Another important, yet often minimized, factor is potential food allergy or sensitivity. Dairy, soy, or gluten sensitivity of baby formula or breast milk (due to certain foods consumed by mother) can play a big role in baby’s symptoms. Formula-fed infants may need to switch to a hypoallergenic formula. Breastfeeding mothers would do well do eliminate foods that commonly trigger sensitivity (such as dairy, soy, and gluten) to determine whether reflux symptoms improve in baby. Re-introducing one food at a time after it has been eliminated (to see if symptoms return when it’s reintroduced) for a few weeks can help to verify the food’s contribution to symptoms. Find an integrative/holistically-minded pediatrician who can help guide this process, instead of one who prescribes acid blockers at the first sign of distress.

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