GERD diagnoses expose infants to overmedication

Physicians’ diagnoses of probable gastroesophageal reflux disease (GERD) in infants who cry and spit up excessively often lead them to overmedicate healthy babies, according to new research.

The study investigating the routine use of drugs to treat infants for suspected GERD found that parents are likely to seek medication for their child’s symptoms even if their health care provider tells them that drugs are not effective.

Researchers gave 175 parents in a general pediatric clinic several hypothetical scenarios in which a doctor gives a healthy infant who cries and often spits up a diagnosis of GERD with offer of medication or in which a doctor does not label the symptoms as a disease and advises parents that the infant will outgrow the symptoms. Half the parents were told that existing medications for GERD were probably ineffective while the other half were not provided any information about effectiveness. Parents answered survey questions based on a scale of 0 to 5.

Parents who received the GERD diagnosis in the scenarios were more interested in using medications than parents who did not receive the label, even when told that medication was likely ineffective. Parents not given a diagnosis of GERD and not told the medications were ineffective also expressed interest in using the drugs.

The number of US infants aged younger than 1 year who were diagnosed with GERD and treated with proton pump inhibitors jumped 700% from 1999 to 2004. Although these medications are effective when GERD is confirmed by endoscopy, clinical trials have shown that acid-reducing drugs work no better than placebo for treating excessive crying and regurgitation in otherwise healthy infants.

Researchers conclude that doctors may inadvertently be encouraging the use of questionable medical intervention by using labels such as GERD that increase parents’ perceived need for treatment. Not only is medicating otherwise healthy infants a needless expense, they say, but the practice may be exposing these children to long-term adverse effects that have not been fully studied.