Why newborns shouldn't be prescribed reflux medications - PPI's or H2 Blockers
Digest these facts…
Research now tells us that ‘there is little evidence that acid plays any role in patterns of unsettledness and irritability in infancy. Furthermore, there is evidence that acid suppression does nothing to improve these distressing behaviours and that PPI and H2 Blocker therapies are associated with important adverse effects.’ 1
Despite this, the rates of prescribing PPI’s and H2 Blockers has greatly risen. ‘Over the past 15 years, many thousands of fussy babies worldwide have been given medicine in the belief that their colic was caused by painful acid reflux, Gastroesophageal Reflux (GER). From 1999-2004 the use of a popular class of liquid antacid (PPI's) in young children increased 16-fold and from 2000-2003 there was a 400% increase in the number of babies treated with anti-reflux medicine. This rate of increase has continued—or accelerated—from 2003 to the present.’ 2
In 2013 omeprazole was the third most commonly dispensed medicine in New Zealand. Between 2006 and 2010 the number of prescriptions dispensed for newborns increased from 4650 to 8231. The largest occurred in the age zero to three months (111%) and four to six months (80%) cohorts. 3
In Partnership Health Primary Health Organisation (PHO), Canterbury, New Zealand, 15% of infants less than one year of age received a prescription for the PPI omeprazole in 2010. Five years earlier in 2005, only 4% of children in this age group were prescribed this drug. 4 I wonder what the number is now? All of these increases are despite FDA regulations.
FDA does not approve PPI’s for newborns
For ranitidine, the safety and efficacy has been established for the 1 month to 16 year age-group for the treatment of GORD/GERD only and should not be taken any longer than 2 weeks.
Use of PPI’s and H2 Blockers are detrimental to a newborns health
PPI’s and H2 Blockers also decreases iron, magnesium and vitamin B12 absorption. Iron deficiency, otherwise known as anaemia, brings tiredness, lethargy, shortness of breath, palpitations, dizziness and light-headedness. A deficiency of magnesium for a newborn can lead to a loss of appetite, a failure to grow, impaired development, muscular irritability, hallucinations, mental confusion, generalized weakness and flaccidity in the body. Occasional spasticity and rigidity in the body can also be present as can muscular tremors, twitches, as well as sleep apnoea. A deficiency in B12 will only show itself outwardly when all of a newborn’s reserves of this important vitamin have been used up and babies are already born with a naturally low supply. Non-absorption or low supplies in the first year of life will see your newborn failing to grow normally with signs of anaemia, fatigue and they may not be able to use their muscles effectively. A B12 deficiency also has the potential to cause severe and irreversible damage, especially to the brain and nervous system. It has been found that levels even slightly lower than normal can result in lethargy, being depressed, numbness or tingling in the hands or feet, confusion, irritability and a poor memory.
Why the drugs seem to settle some babies
What happens when a PPI or H2 Blocker is stopped?
When a newborn is weaned off a PPI or H2 Blocker acid levels spike beyond natural levels which causes heightened unsettledness and in some cases extreme discomfort. If parents reduce the amount without knowing this and without professional help, they understandably think that the drug is working to their baby’s benefit and unfortunately, may place baby back on the reflux medication.
Last Updated: 06 March 2016