Stomach acid inhibiting drugs are popular for treating acid reflux and heartburn, but they can cause some troubling side effects and not just in adults. New research has found that babies are increasingly being prescribed and given PPIs, proton pump inhibitors, and other acid blockers to treat acid reflux, gastroesophageal reflux disease, and similar conditions. This trend is problematic because there is evidence that the use of these drugs could put children at risk for bone fractures.
Use of PPIs in Infants on the Rise
A study from 2007, published in the Journal of the American Medical Association, found that between 1999 and 2004, the use of PPIs in babies one year old or younger had increased significantly. There was a seven-fold increase in the number of prescriptions for babies. The average age at which a baby was first given a PPI according to the study was between four and five months.
This is a change from how infants have been treated for acid reflux symptoms in the past. The symptoms of gastroesophageal reflux disease in an infant are the same as what is more commonly called spitting up. When a baby spits up, the typical treatment is to burp the baby. Babies typically outgrow acid reflux and spitting up by the time they are one year old, and it is a common issue affecting more than half of all babies.
Acid Reflux Medications and Bone Fractures
PPIs have already been shown to increase the risk of bone fractures. The Food and Drug Administration (FDA) issued two warnings about this potential side effect, in 2010 and 2011. The risk is greatest with prescription PPIs taken at larger doses. The drugs can lead to weakened bones and fractures, particularly in hips, wrists, and the spine.
A recent study of the use of PPIs in infants found a disturbing fact: the use of these drugs caused a significant risk of later bones breaks and fractures. Babies given PPIs before six months of age had a 22 percent increased risk of suffering a fractured bone by the age of five or six. The risk was even higher in babies given a combination of a PPI and another kind of acid reflux drug called an H2 blocker. The risk is also connected to the dose and the duration of use of the drugs. Babies who were given one or more of these drugs for a period of 60 to 150 days had an even greater risk of broken bones.
The research results indicate that there are serious risks associated with using acid reflux drugs in babies. The researchers suggest that they should only be used in babies with more severe symptoms, not just for typical spitting up. They also warn against the assumption that over the counter acid reflux drugs are safe. Any use of an acid reflux drug has the potential to increase the risk of childhood fractures and should be limited or used only with the direction of a pediatrician.