Infantile reflux is challenging, for everyone involved. The symptoms of infantile gastro-oesophageal reflux (“reflux”) are often nonspecific, and vary widely (from regurgitation, to coughing, to fussing/refusing to eat, to excessive crying). In rare cases, reflux can cause severe complications, such as failure to thrive, so do seek help if you’re concerned about your little one.
BUT… please know that reflux is actually common in babies.
In fact, up to 65% of infants regurgitate stomach contents at least once a day between 3-6 months. And, in most cases, ‘reflux’ spontaneously resolves, with complete resolution in 95% of babies by the time they’re 12 months old (1, 2).
Even though reflux is considered a relatively common and normal event, protein pump inhibitors (PPIs), which suppress acid secretion in the stomach, are still very often prescribed (1). In fact, they’re one of the most widely used drugs in the world (3). While this can provide symptomatic relief if some cases, PPIs should not be used long-term.
The Problem with PPIs
In adults, PPIs have been associated with increased risks of gastrointestinal and respiratory tract infections, Vitamin B12 deficiency, Magnesium deficiency, bone fractures, chronic kidney disease, cognitive decline, and rebound hyperacidity after discontinuation (3). PPIs can also cause imbalances of the all-important microbiome.
Given how immature an infant’s digestive system is, and how serious some of these side effects are in adult populations, the use of PPIs in infants is worrisome.
What does the research show regarding the use of PPIs for infantile reflux?
“PPIs should be used only after nonpharmacological measures have been taken with incomplete success” (1)
“Clinical trials show that PPI treatment is not effective for reflux symptoms in infants and there is insufficient evidence of their use” (1)
“PPIs are not effective in reducing GERD symptoms in infants” (2)
“If the primary aim is to treat GERD symptoms in infants, PPIs should not be prescribed” (2)
This begs the question, what else can be done? Here are some of my recommendations:
Often, if the mum is breastfeeding, I’ll also support her using specific strains of probiotics and carminative herbal medicines that are safe during lactation (such as chamomile and lemon balm).
As I said, infantile reflux is challenging, for everyone involved. Hang in there mama’s (and papa’s), know your options and don’t be afraid to ask for help! For more information on infant nutrition and introducing solids, head here.
Until next time,
Stacey.