Researchers say many antacids are ineffective in helping stomach problems, and some may increase a baby’s risk for bone fractures.
An infant’s pain or distress can be heartbreaking to watch for some new parents.
We instinctively want to make them better as quickly as possible. But sometimes the easiest solution comes with unintended consequences.
A new study published this month in the journal Pediatrics concludes that infants who are given antacids in their first year of life have a significantly higher risk for bone fractures as they get older.
Infant reflux, also called gastroesophageal reflux (GER), is when stomach acid flows back into the tube connecting a baby’s mouth and stomach. It’s one reason why babies spit up.
“Infant reflux is common and normal in young infants and is frequently implicated as a cause of fussiness by parents and providers,” Elizabeth Hisle-Gorman, PhD, the study’s corresponding author and an assistant professor of pediatrics at Uniformed Services University of the Health Sciences in Maryland, told Healthline.
“While acid suppression in infants may be appropriate in certain cases of gastroesophageal reflux disease, there’s a growing body of
According to Hisle-Gorman, her study adds to the evidence against antacid use for infants “by finding that there also may be adverse effects on bone health, leading to an increased risk for fracture.”
“Our study and prior research on adverse effects of acid-suppressive medications suggest that [antacid] use in infancy should be avoided if possible, and when necessary should be initiated at older ages and prescribed for as short a period as possible,” she said.
Dr. Jacqueline Jossen, an assistant professor of pediatric gastroenterology at Mount Sinai Hospital in New York, notes that GER is simply “the movement of stomach contents backward into the esophagus that can be accompanied by regurgitation or vomiting.”
In most cases, it’s nothing to worry about.
“It’s a normal physiologic process in healthy infants, and we refer to these babies as ‘happy spitters,'” Jossen told Healthline.
However, Jossen says when the symptoms of reflux become more serious, there can be adverse consequences.
These include poor eating habits, significant discomfort, and lower weight gain.
That’s when a D is added to designate GERD, a disease adversely affecting a baby’s health.
Common antacids neutralize the body’s stomach acid to reduce the symptoms of acid reflux and heartburn.
These over-the-counter antacids include:
- Milk of Magnesia
But there are two types of powerful antacids that have broader effects on the stomach.
It’s these that Hisle-Gorman’s study concluded can increase the risk of fracture in children.
H2 blockers, also called histamine H2 receptor antagonists, work by actually decreasing the amount of acid produced by the stomach, rather than neutralizing what’s already there. They include famotidine (Pepcid) and ranitidine (Zantac).
Proton pump inhibitors (PPIs) are now the most commonly prescribed class of medication to relieve stomach acid-related disorders.
They work by completely blocking the cells that produce acid.
Examples of PPIs include lansoprazole (Prevacid) and omeprazole (Prilosec).
Antacids aren’t the only way to relieve GER symptoms.
There are simple actions parents can take on their own.
“I always recommend behavioral interventions before moving on to other options,” Jossen said.
She recommends that parents try “smaller, more frequent feeds and holding the infant upright for at least 20 minutes after a bottle as the first intervention.”
“They should also be sure the babies are burping adequately,” she said, “and when bottle-feeding, check if the flow of the nipple is too fast.”
Jossen explains that a milk allergy may also be the reason for GER symptoms.
In that case, she recommends a replacement.
“Giving a hypoallergenic formula for two to four weeks may be tried,” she said. “Although one of the typical symptoms for milk protein intolerance is blood in the stool, there are some infants intolerant to cow’s milk that may show significant GER symptoms instead.”
Jossen adds that if making those adjustments doesn’t work and GER is still an issue, then she would consider other approaches.
As distressing as watching your child spit up and cry after feeding can be, Jossen reminds parents that this is a condition that almost always improves with time.
“Both GER and GERD will improve with time, and the prognosis is good,” she said. “I generally tell parents that once a baby can sit, the symptoms really should start improving, and the majority of either condition resolves by the time baby begins to walk.”
“In typical GER or GERD, there are no long-term consequences,” she added, “and I do not anticipate that these infants will be more prone to gastrointestinal issues than other children in the future.”
Some infants can experience excessive spitting up and discomfort after feeding that’s called gastroesophageal reflux, or GER.
When the symptoms are bad enough that a baby doesn’t put on weight and experiences prolonged discomfort, it’s called GERD.
Antacids can relieve these symptoms.
However, recent research concludes these drugs may be ineffective. Certain classes of antacids may also raise the risk of bone fracture.
Experts say there are methods and dietary changes that should be tried first before using medications.